Piil Karin, Jarden Mary
Questions or comments about this article may be directed to Karin Piil, PhD MHScN RN, at
J Neurosci Nurs. 2018 Apr;50(2):94-99. doi: 10.1097/JNN.0000000000000348.
The disease and treatment trajectory of patients with high-grade glioma is a burdensome period for the patients' closest relatives who become informal caregivers. Caregivers experiencing this demanding shift in role are at risk of developing symptoms such as depression. Few studies have explored the needs and experiences of bereaved caregivers, and there is lack of evidence-based practice. This study explores the perspectives of newly bereaved caregivers to patients with high-grade glioma on end-of-life caregiving and bereavement.
This qualitative exploratory study was composed of individual semistructured telephone interviews with bereaved caregivers (n = 8) to patients with high-grade glioma who deceased during participation in the mixed-methods Neuro-oncological Rehabilitation study. A thematic analysis was conducted following Braun and Clarke's guidelines.
Four main themes were identified concerning the bereavement experience: (1) late-stage caregiving is comprehensive and taxing, (2) releasing the responsibility of the primary caregiving role, (3) feelings of grief and relief, and (4) suggestions for clinical practice.
Late-stage caregiving is a difficult and challenging experience at the end of an already burdening treatment trajectory. Caregivers prefer to actively share responsibility and practical tasks with professionals, family, and friends. The bereaved caregivers' key areas of concern indicate the need for additional research in advance care planning within neuro-oncology caregiving to establish evidence-based practice guidelines and recommendations.
对于成为非正式照料者的高级别胶质瘤患者的至亲而言,患者的疾病及治疗历程是一段负担沉重的时期。经历这种角色急剧转变的照料者有出现诸如抑郁等症状的风险。很少有研究探讨过失去亲人的照料者的需求和经历,且缺乏循证实践。本研究探讨了新近失去亲人的高级别胶质瘤患者照料者在临终关怀及丧亲之痛方面的观点。
这项定性探索性研究由对8名参与混合方法神经肿瘤康复研究期间其照料的高级别胶质瘤患者已去世的失去亲人的照料者进行的半结构化电话访谈组成。按照布劳恩和克拉克的指导方针进行了主题分析。
确定了与丧亲经历相关的四个主要主题:(1)晚期照料全面且费力,(2)卸下主要照料角色的责任,(3)悲伤与解脱之感,以及(4)对临床实践的建议。
在已然负担沉重的治疗历程末期,晚期照料是一段艰难且具有挑战性的经历。照料者更倾向于与专业人员、家人和朋友积极分担责任及实际任务。失去亲人的照料者所关注的关键领域表明,需要在神经肿瘤照料的预先护理规划方面开展更多研究,以制定循证实践指南和建议。