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从临终关怀家庭照顾者角度看疼痛管理问题

Pain Management Concerns From the Hospice Family Caregivers' Perspective.

作者信息

Chi Nai-Ching, Demiris George, Pike Kenneth C, Washington Karla, Oliver Debra Parker

机构信息

1 College of Nursing, University of Iowa, Iowa City, IA, USA.

2 Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA.

出版信息

Am J Hosp Palliat Care. 2018 Apr;35(4):601-611. doi: 10.1177/1049909117729477. Epub 2017 Sep 6.

Abstract

BACKGROUND

Pain management is a challenging task for family caregivers in home hospice care. However, there are limited studies that examine the challenges regarding pain management in hospice care from family caregivers' perspectives.

OBJECTIVES

To identify the challenges related to pain management faced by family caregivers in hospice care and to examine the validity of an existing framework that outlines pain management challenges for hospice family caregivers.

DESIGN

We conducted a theory-driven, deductive content analysis of secondary data obtained from hospice family caregivers' interviews from a randomized clinical trial.

SETTING/PARTICIPANTS: We included baseline interviews of 15 hospice caregivers of patients from hospice agencies in the States of Washington. The majority of the participants were white and female caregivers. They were spouse/partner or adult child living with the patient.

RESULTS

The study identified 5 out of the 6 major themes in the original framework and confirmed that hospice family caregivers face a variety of challenges: caregiver-centric issues, caregiver's medication skills and knowledge, communication and teamwork, organizational skill, and patient-centric issues. A couple of the subthemes in the original framework were not present in our findings. We also expanded the original framework by adding 1 subtheme and revised 2 definitions in the original framework.

CONCLUSION

The study provided an investigation on hospice family caregivers' difficulties in pain management. The results can inform health-care providers and researchers of family caregivers' challenges and provide insights for future designs of educational tools targeting pain management strategies, so that family caregivers can perform pain management effectively at home.

摘要

背景

对于居家临终关怀中的家庭照护者而言,疼痛管理是一项具有挑战性的任务。然而,从家庭照护者的角度审视临终关怀中疼痛管理挑战的研究有限。

目的

确定临终关怀中家庭照护者在疼痛管理方面面临的挑战,并检验一个概述临终关怀家庭照护者疼痛管理挑战的现有框架的有效性。

设计

我们对从一项随机临床试验中获取的临终关怀家庭照护者访谈的二手数据进行了理论驱动的演绎性内容分析。

设置/参与者:我们纳入了华盛顿州临终关怀机构中15名患者的临终关怀照护者的基线访谈。大多数参与者是白人女性照护者。他们是与患者同住的配偶/伴侣或成年子女。

结果

该研究在原始框架的6个主要主题中确定了5个,并证实临终关怀家庭照护者面临各种挑战:以照护者为中心的问题、照护者的用药技能和知识、沟通与团队合作、组织技能以及以患者为中心的问题。我们的研究结果中未出现原始框架中的几个子主题。我们还通过添加1个子主题扩展了原始框架,并修订了原始框架中的2个定义。

结论

该研究调查了临终关怀家庭照护者在疼痛管理方面的困难。研究结果可为医疗保健提供者和研究人员提供有关家庭照护者挑战的信息,并为未来针对疼痛管理策略的教育工具设计提供见解,以便家庭照护者能够在家中有效地进行疼痛管理。

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Pain Management Concerns From the Hospice Family Caregivers' Perspective.从临终关怀家庭照顾者角度看疼痛管理问题
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