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“陪伴”还是“做事”?终末期志愿者陪伴者的角色如何影响患者的幸福感:来自一项多案例定性研究(ELSA)的访谈。

'Being with' or 'doing for'? How the role of an end-of-life volunteer befriender can impact patient wellbeing: interviews from a multiple qualitative case study (ELSA).

机构信息

International Observatory on End of Life Care, Division of Health Research, Furness Building, Lancaster University, Bailrigg, Lancaster, LA1 4YG, UK.

Institute for Volunteering Research, NCVO, Society Building, 8 All Saints Street, London, N1 9RL, UK.

出版信息

Support Care Cancer. 2018 Sep;26(9):3163-3172. doi: 10.1007/s00520-018-4169-2. Epub 2018 Mar 29.

Abstract

PURPOSE

To explore the perspectives of people anticipated to be in their last year of life, family carers, volunteers and staff on the impacts of receiving a volunteer-provided befriending service. Patient participants received up to 12 weeks of a volunteer-provided befriending intervention. Typically, this involved one visit per week from a trained volunteer. Such services complement usual care and are hoped to enhance quality of life.

METHODS

Multiple case study design (n = 8). Cases were end-of-life befriending services in home and community settings including UK-based hospices (n = 6), an acute hospital (n = 1) and a charity providing support to those with substance abuse issues (n = 1). Data collection incorporated qualitative thematic interviews, observation and documentary analysis. Framework analysis facilitated within and across case pattern matching.

RESULTS

Eighty-four people participated across eight sites (cases), including patients (n = 23), carers (n = 3), volunteers (n = 24) and staff (n = 34). Interview data are reported here. Two main forms of input were described-'being there' and 'doing for'. 'Being there' encapsulated the importance of companionship and the relational dynamic between volunteer and patient. 'Doing for' described the process of meeting social needs such as being able to leave the house with the volunteer. These had impacts on wellbeing with people describing feeling less lonely, isolated, depressed and/or anxious.

CONCLUSION

Impacts from volunteer befriending or neighbour services may be achieved through volunteers taking a more practical/goal-based orientation to their role and/or taking a more relational and emotional orientation. Training of volunteers must equip them to be aware of these differing elements of the role and sensitive to when they may create most impact.

TRIAL REGISTRATION

ISRCTN12929812.

摘要

目的

探讨预期生命最后一年的患者、家属照顾者、志愿者和工作人员对接受志愿者提供的陪伴服务的影响的看法。患者参与者接受了长达 12 周的志愿者提供的陪伴干预。通常情况下,这包括每周由一名经过培训的志愿者进行一次访问。此类服务是对常规护理的补充,希望能提高生活质量。

方法

采用多案例研究设计(n=8)。案例包括临终陪伴服务,地点在家庭和社区,包括英国的临终关怀机构(n=6)、一家急症医院(n=1)和一家为滥用药物问题提供支持的慈善机构(n=1)。数据收集包括定性主题访谈、观察和文件分析。框架分析促进了案例内和案例间的模式匹配。

结果

在八个地点(案例)共有 84 人参与,包括患者(n=23)、照顾者(n=3)、志愿者(n=24)和工作人员(n=34)。此处报告的是访谈数据。描述了两种主要的输入形式——“在场”和“做事”。“在场”体现了陪伴的重要性和志愿者与患者之间的关系动态。“做事”描述了满足社交需求的过程,例如能够与志愿者一起离开家。这些都对幸福感产生了影响,人们表示感到不那么孤独、孤立、抑郁和/或焦虑。

结论

志愿者陪伴或邻里服务的影响可能是通过志愿者对其角色采取更实际/以目标为导向的方法,或者采取更关系和情感导向的方法来实现的。志愿者培训必须使他们意识到角色的这些不同要素,并对何时可能产生最大影响保持敏感。

试验注册

ISRCTN86041212。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/262b/6096531/4e3585cad173/520_2018_4169_Fig1_HTML.jpg

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