Department for Palliative Care and Organisational Ethics, Institute of Pastoral Theology, University of Graz, Graz, Austria.
Institute of Palliative Care and Organisational Ethics, University of Klagenfurt, Vienna, Austria.
Sociol Health Illn. 2020 Jun;42(5):987-1000. doi: 10.1111/1467-9566.12738. Epub 2018 Apr 27.
In accordance with the pluralisation of life plans in late modernity, the societal organisation of care at the end of life is diverse. Although the public discourse in western societies is dominated by questions about optimising specialised palliative care services, public health approaches, which take into account the social determinants and inequalities in end-of-life care, have gained in importance over the last decade. Conceptual aspects, dimensions of impact and benefit for the dying and their communities are well discussed in the public health end-of-life care research literature. Our research focuses on the preconditions of a supportive caring web in order to understand how communities can build on their social capital to deal with existential uncertainty. As part of a large-scale community research project, we carried out focus groups and interviews with community members. Through dispositive analysis, we generated a set of care-web 'ingredients', which constitute and foster a caring community. These 'ingredients' need to be cultivated through an ongoing process of co-creation. This requires: (i) a focus on relationships and social systems; (ii) the creation of reflective spaces; and (iii) the strengthening of social capital, and d) the addressing of inequalities in care.
根据后现代主义中生命计划的多元化，生命末期的关怀社会组织形式也呈现多样化。尽管西方社会的公共话语主要围绕着优化专门的姑息治疗服务提出问题，但在过去十年中，考虑到生命末期关怀的社会决定因素和不平等问题的公共卫生方法已经变得越来越重要。在公共卫生临终关怀研究文献中，对概念方面、影响和受益维度以及临终患者及其社区进行了充分讨论。我们的研究侧重于支持性关怀网络的前提条件，以了解社区如何利用其社会资本来应对存在的不确定性。作为一个大型社区研究项目的一部分，我们对社区成员进行了焦点小组和访谈。通过话语分析，我们生成了一套关怀网络“要素”，这些要素构成并促进了关怀社区。这些“要素”需要通过持续的共创过程来培养。这需要：（i）关注关系和社会系统；（ii）创造反思空间；（iii）加强社会资本，以及（iv）解决关怀中的不平等问题。
