Aarhus University, Denmark.
Aarhus University, Denmark; University of the Faroe Islands, Faroe Islands.
Nurs Ethics. 2020 Mar;27(2):587-597. doi: 10.1177/0969733019857790. Epub 2019 Jul 18.
Caring for a partner with primary malignant brain tumour can be a dramatic life-changing event. Primary malignant brain tumour is known to give poor life expectancy and severe neurological and cognitive symptoms, such as changed behaviour and personality, which demand greater caring responsibilities from spouses.
The aim of the study is to explore ethical dilemmas spouses experience in the everyday care of a partner in treatment for primary malignant brain tumour.
RESEARCH DESIGN, PARTICIPANTS AND RESEARCH CONTEXT: A phenomenological and hermeneutic qualitative descriptive design was adopted as a method for collecting and analysing data. Ten spouses were interviewed twice using an in-depth, semi-structured interview guide. The interviews took place at the spouses' homes or at the hospital.
Ethical matters were considered throughout the research process. Permission from The National Committee on Health Research Ethics and the Danish Data Protection Agency was obtained.
The analysis showed that the spouses perceived daily ethical dilemmas in caring for a partner with primary malignant brain tumour. Their life as well as their partner's life had changed considerably. The main theme that emerged therefore was 'oscillating in a changing relationship'. This theme was further elaborated in three subthemes that in more detail demonstrated the dilemmas: 'doing the right thing in unpredictable daily situations'; 'torn between patience and guilt'; and 'living in a time of uncertainty, hope and despair'.
Caring for a partner with changed behaviour and personality due to primary malignant brain tumour may involve exhausting ethical caring dilemmas. Spouses' married life may change to a semi-professional asymmetrical relationship, which is challenged by the oscillation between acting responsibly for their partners' well-being and caring dilemmas with no answer for what the right thing to do is. Mixed feelings of right and wrong, patience and guilt, hope and despair seem to be spousal companions through their partners' progressing illness.
照顾患有原发性恶性脑肿瘤的伴侣可能是一个戏剧性的、改变生活的事件。原发性恶性脑肿瘤的预期寿命通常较差,并且会导致严重的神经和认知症状,例如行为和性格改变,这需要配偶承担更多的照顾责任。
本研究旨在探讨配偶在照顾原发性恶性脑肿瘤治疗伴侣的日常护理中所经历的伦理困境。
研究设计、参与者和研究背景:采用现象学和解释学的定性描述设计方法来收集和分析数据。10 名配偶使用深入的半结构化访谈指南进行了两次访谈。访谈在配偶的家中或医院进行。
在整个研究过程中都考虑了伦理问题。获得了国家卫生研究伦理委员会和丹麦数据保护局的许可。
分析显示,配偶在照顾原发性恶性脑肿瘤患者时会遇到日常的伦理困境。他们的生活和伴侣的生活都发生了巨大的变化。因此,出现的主要主题是“在变化的关系中摇摆不定”。这一主题进一步通过三个子主题展开,更详细地展示了这些困境:“在不可预测的日常情况下做正确的事”;“在耐心和内疚之间挣扎”;以及“生活在不确定、希望和绝望的时代”。
由于原发性恶性脑肿瘤导致行为和性格改变,照顾伴侣可能涉及令人筋疲力尽的伦理困境。配偶的婚姻生活可能会转变为一种半专业的不对称关系,这种关系受到为伴侣的幸福负责与没有答案的照顾困境之间的摇摆所挑战,而什么是正确的事情做是不确定的。正确与错误、耐心与内疚、希望与绝望的混合感受似乎是配偶在伴侣病情进展过程中的伴侣。