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患者-家庭单位的尊严:临终关怀中的进一步理解。

Dignity of the patient--family unit: further understanding in hospice palliative care.

机构信息

School of Nursing, Capital Medical University, Beijing, China

Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China

出版信息

BMJ Support Palliat Care. 2022 Oct;12(e4):e599-e606. doi: 10.1136/bmjspcare-2019-001834. Epub 2019 Jul 14.

Abstract

OBJECTIVES

This study aimed to explore the construct of dignity of the patient-family dyad in hospice palliative care, as well as its influencing factors from the perspective of hospice palliative care staff.

METHODS

A qualitative descriptive study was conducted with 34 staff members from a residential hospice in Amherst, USA, and an inpatient palliative care unit in Winnipeg, Canada, between September 2013 and December 2016. Data were collected through semistructured interviews and were analysed using the thematic analysis approach.

RESULTS

Findings suggested that staff members viewed dignity as something that is reciprocally supported within the patient-family unit. Themes including respect, comfort, privacy, being informed and quality family time were common in the conceptualisation of dignity in patients and families; themes of being human and being self, autonomy and living with dignity were uniquely used to conceptualise patient dignity. Themes solely constituting family dignity included being included in care, being capable and being treated fairly. Cultural considerations, environmental factors, teamwork and patient/family-staff relationship were the factors identified by staff members that affected dignity in hospice palliative care.

CONCLUSION

Findings of this study provide insights into the development of strategies to support the dignity of the patient-family unit in hospice palliative care.

摘要

目的

本研究旨在从临终关怀工作人员的角度探讨临终关怀中患者-家庭联合体的尊严的构建及其影响因素。

方法

本研究采用定性描述性研究方法,于 2013 年 9 月至 2016 年 12 月,选取美国阿默斯特的一家临终关怀院和加拿大温尼伯的一家姑息治疗住院病房的 34 名工作人员作为研究对象,通过半结构式访谈收集资料,并采用主题分析法进行分析。

结果

研究结果表明,工作人员认为尊严是在患者-家庭单元中相互支持的东西。在患者和家庭尊严的概念化中,常见的主题包括尊重、舒适、隐私、知情和高质量的家庭时间;主题包括人性和自我、自主性和有尊严地生活被独特地用于概念化患者尊严。唯一构成家庭尊严的主题包括被纳入关怀、有能力和公平对待。工作人员确定的影响临终关怀中尊严的因素包括文化考虑、环境因素、团队合作和患者/家庭-工作人员关系。

结论

本研究结果为制定支持临终关怀中患者-家庭联合体尊严的策略提供了见解。

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