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家庭与朋友间临终沟通的矛盾与前景:“晚餐谈死亡”对话

Contradictions and Promise for End-of-Life Communication among Family and Friends: Death over Dinner Conversations.

作者信息

Lambert South Andrea, Elton Jessica

机构信息

Department of Communication, Northern Kentucky University, Highland Heights, KY 41099, USA.

Department of Communication, Eastern Michigan University, Ypsilanti, MI 48197, USA.

出版信息

Behav Sci (Basel). 2017 Apr 20;7(2):24. doi: 10.3390/bs7020024.

Abstract

The free, open-access website called "Let's Get Together and Talk about Death", or Death over Dinner (DoD), provides resources for initiating end-of-life conversations with family and friends by taking the frightening-talking about death-and transforming it into the familiar-a conversation over dinner. This qualitative, descriptive study uses grounded theory and thematic analysis to answer the following research question: How do friend and family groups communicate about death and dying in DoD conversations? To answer this question, 52 dinner groups were recruited and conversations were conducted, which consisted of a facilitator and volunteers. The facilitators were the researchers or research assistants who allowed dinner participants to control the conversation and identify topics of interest, and participants were free to share as much or as little as they wanted. Our analysis revealed that family and friend groups communicated similarly in that they talked about similar topics and used similar communication strategies to discuss those topics. Three major themes emerged: , which juxtaposed people's perceptions of a "dreaded" death with those of a "desirable" death; , which consisted of the subthemes of humour to diffuse tension or deflect discomfort, spiritual reassurance, and topic avoidance; and , which consisted of the subthemes of organ and whole-body donation, hospice and palliative care, wills and advance directives. Ultimately, however, participants felt their experiences were positive and DoD shows promise as a tool for families to engage in end-of-life conversations.

摘要

一个名为“让我们聚在一起聊聊死亡”(Let's Get Together and Talk about Death)的免费开放获取网站,即“晚餐谈死亡”(Death over Dinner,简称DoD),通过将谈论死亡这种令人恐惧的事情转变为像晚餐时聊天这样熟悉的场景,为与家人和朋友开启临终话题对话提供资源。这项质性描述性研究运用扎根理论和主题分析法来回答以下研究问题:在“晚餐谈死亡”的对话中,朋友和家庭群体是如何交流死亡和临终相关话题的?为回答这个问题,招募了52个晚餐小组并开展对话,对话由一名主持人和志愿者组成。主持人是研究人员或研究助理,他们让晚餐参与者主导对话并确定感兴趣的话题,参与者可以自由分享,想说多少就说多少。我们的分析表明,家庭和朋友群体的交流方式相似,他们谈论相似的话题,并使用相似的沟通策略来讨论这些话题。出现了三个主要主题:一是将人们对“可怕”死亡的认知与“理想”死亡的认知并列;二是由缓解紧张或转移不适的幽默、精神慰藉和话题回避等子主题组成;三是由器官和全身捐赠、临终关怀与姑息治疗、遗嘱和预先医疗指示等子主题组成。然而,最终参与者觉得他们的体验是积极的,并且“晚餐谈死亡”作为家庭参与临终对话的工具显示出了潜力。

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