St John's Hospice, London, UK.
Universidad de Navarra, ICS, ATLANTES, Campus Universitario, 31080, Pamplona, España.
BMC Palliat Care. 2017 Sep 6;16(1):47. doi: 10.1186/s12904-017-0229-5.
Family members are involved in the care of palliative patients at home and therefore, should be viewed as important sources of information to help clinicians better understand the quality palliative care service patients receive. The objective of the study was to analyse what is valued most by family carers undergoing bereavement of a palliative care home service in order to identify factors of quality of care.
Qualitative exploratory study based on documentary analysis. Content analysis of 77 gratitude documents received over 8 years by a palliative home service in Odivelas, near Lisbon (Portugal) was undertaken, through an inductive approach and using investigator triangulation. Frequency of distinct categories was quantitatively defined.
Three different content categories emerged from the analysis: a) Recognition of the care received and the value of particular aspects of care within recognised difficult situations included aspects such as kindness, listening, attention to the family, empathy, closeness, affection and the therapeutic relationships established (63/77 documents); b) Family recognition of the achievements of the palliative care team (29/77) indicated as relief from suffering for the patient and family, opportunity of dying at home, help in facing difficult situations, improvement in quality of life and wellbeing, and feeling of serenity during bereavement; c) Messages of support (45/77) related to the need of resources provided. The relational component emerges as an underlying key aspect of family carers' experience with palliative care home service.
Family carers show spontaneous gratitude for the professionalism and humanity found in palliative care. The relational component of care emerges as key to achieve a high quality care experience of palliative care homes service, and could be one indicator of quality of palliative care.
家庭成员在家中参与姑息治疗患者的护理，因此，应将其视为帮助临床医生更好地了解患者接受姑息治疗服务质量的重要信息来源。本研究的目的是分析丧亲的姑息治疗居家服务家庭照顾者最看重的是什么，以确定护理质量的因素。
这是一项基于文献分析的定性探索性研究。通过归纳法和使用调查员三角测量法，对 8 年来里斯本附近奥维多拉斯姑息治疗居家服务收到的 77 份感恩文件进行内容分析。对不同类别的频率进行了定量定义。
从分析中出现了三个不同的内容类别：a）认可所接受的护理以及在公认困难情况下护理的某些方面的价值，包括善良、倾听、关注家庭、同理心、亲近、感情和建立的治疗关系（63/77 份文件）；b）家庭对姑息治疗团队成就的认可，表明患者和家庭的痛苦减轻，有机会在家中死亡，得到面对困难情况的帮助，生活质量和幸福感提高，以及在丧亲期间感到平静（29/77）；c）支持信息（45/77）与提供资源的需求有关。关系要素是家庭照顾者对姑息治疗居家服务体验的一个关键方面。
家庭照顾者对姑息治疗中发现的专业精神和人性表示自发的感激。护理的关系要素是实现姑息治疗居家服务高质量护理体验的关键，并且可以作为姑息治疗质量的一个指标。
