Department of Health Sciences, Faculty of Medicine, Lund University, Lund, SE-221 00, Sweden.
Faculty of Health Science, Kristianstad University, Kristianstad, SE-291 88, Sweden.
BMC Geriatr. 2019 Nov 21;19(1):324. doi: 10.1186/s12877-019-1343-4.
The length of stay in nursing homes before death in Sweden has significantly decreased, and nearly one-third of people die within 6 weeks of entering a nursing home. Support for the next of kin is one of the cornerstones of palliative care, but the principles are not always adhered to as recommended when caring for the elderly, which can affect the quality of life of their next of kin. The aim of this study was to explore the experiences of quality of life among the next of kin of older persons who live in nursing homes before an educational intervention of palliative care.
This is an explorative qualitative interview study with 40 next of kin using qualitative content analysis performed at baseline before the implementation of the principles of palliative care in nursing homes.
The next of kin's experiences of quality of life were expressed in three themes: Orientation to the new life situation, Challenges in their relationship and the Significance of the quality of care in the nursing home. The next of kin experienced a sense of relief, although the older person was constantly on their minds, and they could feel lonely. The difference in the couple'slife situations was experienced as burdensome by the next of kin. The challenges in the relationship were described as stressful, related to a guilty conscience and the older person's vulnerability. The nursing home could be a context facilitating good relations. The perceptions of quality of care in terms of person-centredness affected the quality of life of the next of kin.
The findings show that four factors are decisive for the quality of life of next of kin: the relationships within the family, the degree of relief that nursing home care entails as compared to home care, the older person's health status and whether the care is person-centred. Increased knowledge and education regarding palliative care in nursing homes are needed to better meet the needs of next of kin. Implementation of palliative care should take into account the need for support for next of kin.
NCT02708498, 15 March 2016.
瑞典养老院中死亡前的住院时间显著缩短，近三分之一的人在入住养老院后 6 周内死亡。亲属支持是姑息治疗的基石之一，但在照顾老年人时，并不总是按照建议遵循这些原则，这会影响他们亲属的生活质量。本研究的目的是探讨姑息护理教育干预前居住在养老院的老年人的亲属生活质量体验。
这是一项探索性的定性访谈研究，使用定性内容分析，在姑息护理原则在养老院实施之前，对 40 名亲属进行基线访谈。
亲属的生活质量体验可以概括为三个主题：适应新的生活环境、他们之间的关系挑战和养老院护理质量的意义。亲属感到欣慰，尽管老人一直萦绕在他们心头，他们可能会感到孤独。夫妻生活状况的差异让亲属感到负担沉重。亲属之间关系的挑战被描述为压力大，与内疚感和老人的脆弱性有关。养老院可以成为促进良好关系的环境。对以患者为中心的护理质量的看法影响了亲属的生活质量。
研究结果表明，有四个因素对亲属的生活质量具有决定性作用：家庭内部关系、养老院护理与家庭护理相比带来的缓解程度、老人的健康状况以及护理是否以患者为中心。需要增加对姑息护理在养老院中的知识和教育，以更好地满足亲属的需求。姑息护理的实施应考虑到亲属支持的需求。
NCT02708498，2016 年 3 月 15 日。
