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让她掌控自己的生命终点:关于照料患运动神经元病亲人的进一步思考

Making her end of life her own: further reflections on supporting a loved one with motor neurone disease.

作者信息

Harris Denise Andrea, Jack Kirsten, Wibberley Christopher

机构信息

Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester.

Reader in Learning and Teaching Development Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester.

出版信息

Int J Palliat Nurs. 2019 Jun 2;25(6):284-292. doi: 10.12968/ijpn.2019.25.6.284.

Abstract

BACKGROUND

People can live for many months without knowing why their body is failing prematurely before being diagnosed with motor neurone disease (MND); a terminal neurodegenerative disease which can be experienced as 'devastating' for the person and their family.

AIM

This study aimed to explore the meaning of supporting a loved one with MND to die.

METHODS

This study uses reflection and autobiographical story to connect with broader cultural, political and social meaning and understandings of dying.

FINDINGS

Four themes were identified relating to the end-of-life trajectory of MND. Loss of person (lived body experienced in silence); loss of relationships (lived relations are challenged); loss of home and loss of time (lived space and lived time take on new meaning); loss of future (dying-facing it alone).

CONCLUSION

Dying with MND is a complex phenomenon. When a person can no longer move and communicate, relationships between those involved in end-of-life care are challenging. A person with MND needs the support from those acting as power of attorney to make their end of life their own, and they themselves need support to find meaning in their suffering. This autoethnographic reflection provides vicarious experiences for nurses and other healthcare professionals working with people with MND and similar conditions.

摘要

背景

在被诊断出患有运动神经元病(MND)之前,人们可能在数月内都不知道自己的身体为何过早衰弱;运动神经元病是一种晚期神经退行性疾病,对患者及其家人来说可能是“毁灭性的”。

目的

本研究旨在探讨支持患有运动神经元病的亲人离世的意义。

方法

本研究运用反思和自传体故事来联系更广泛的文化、政治和社会意义以及对死亡的理解。

研究结果

确定了与运动神经元病临终轨迹相关的四个主题。人的丧失(无声体验的活体);关系的丧失(现存关系受到挑战);家园的丧失和时间的丧失(现存空间和现存时间具有了新意义);未来的丧失(独自面对死亡)。

结论

死于运动神经元病是一种复杂的现象。当一个人无法再行动和交流时,参与临终护理的人员之间的关系就会面临挑战。患有运动神经元病的人需要那些担任委托代理人的人的支持,以使他们的生命终结由自己掌控,而且他们自己也需要支持来从痛苦中找到意义。这种自我民族志反思为护理人员和其他与患有运动神经元病及类似病症的人打交道的医疗保健专业人员提供了替代性体验。

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