School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK; School of Heath Sciences, Department of Nursing, Istanbul Arel University, Istanbul, Turkey.
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK; Florence Nightingale Foundation Clinical Professor of Nursing, School of Medicine, Dentistry & Nursing, and NHS Greater Glasgow and Clyde, College of Medical, Veterinary & Life Sciences, University of Glasgow, 57-61 Oakfield Avenue, Glasgow G12 8LL, Scotland, UK.
Int J Nurs Stud. 2020 Aug;108:103584. doi: 10.1016/j.ijnurstu.2020.103584. Epub 2020 May 6.
'Living in the moment' is an essential part of dignity-conserving practice in end-of-life care settings. Although living in the moment is important for care at the end of life, from the perspective of both the person and their family, there is no clear conceptual understanding of what it represents.
To explore the concept of 'living in the moment' in the context of dignity-conserving care at the end of life.
A concept analysis.
The databases of Medline, CinAHL, PubMed, Web of Science, PsycINFO, SocINDEX and Cochrane were searched for studies published between 1941 and 2019, and searches of dictionaries and grey literature, as well as hand-searching were conducted, to yield qualitative, mixed methods and systematic reviews published in English, related to the term 'living in the moment'.
The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of 'living in the moment'.
The literature review generated a total of 37 papers for this concept analysis. The attributes identified were (1) simple pleasure, (2) prioritising relationships, (3) living each day to the fullest, (4) maintaining normality, and (5) not worrying about the future. The antecedents were (1) awareness of dying, (2) living with life-threatening illness, (3) positive individual growth, and (4) living with an uncertain future. The consequences were (1) a good quality of life, (2) preserving dignity, and (3) coping with the uncertainty of life.
A universal definition and conceptual model of the main concept, including theoretical relationships between its antecedents, attributes and consequences, was developed. The definition and proposed conceptual model can allow instruments to be developed that measure the effects, existence or attributes of the concept, and identify a theoretical model, and can also lead to new perspectives and strategies for implementation by nurses to improve dignified person-centred care at the end of life.
“活在当下”是临终关怀实践中维护尊严的重要组成部分。尽管活在当下对生命末期的关怀很重要，无论是对患者还是其家属而言，都没有对其代表的含义有明确的概念理解。
探索生命末期尊严维持关怀背景下“活在当下”的概念。
概念分析。
对 Medline、CinAHL、PubMed、Web of Science、PsycINFO、SocINDEX 和 Cochrane 数据库进行了检索，以获取 1941 年至 2019 年期间发表的研究，并对字典和灰色文献进行了检索，以及进行了手工检索，以获取与“活在当下”一词相关的发表在英文期刊上的定性、混合方法和系统评价。
采用沃克和奥范特的方法，确定“活在当下”概念的前因、属性和结果。
文献综述共生成了 37 篇与该概念分析相关的论文。确定的属性有：（1）单纯的快乐，（2）优先考虑人际关系，（3）充分享受每一天，（4）保持常态，（5）不担心未来。前因包括：（1）意识到死亡，（2）患有危及生命的疾病，（3）积极的个体成长，（4）生活在不确定的未来。结果是：（1）生活质量良好，（2）维护尊严，（3）应对生活的不确定性。
提出了一个通用的定义和主要概念的概念模型，包括其前因、属性和结果之间的理论关系。这个定义和提出的概念模型可以开发出衡量概念的效果、存在或属性的工具，确定一个理论模型，还可以为护士提供新的视角和实施策略，以改善生命末期有尊严的以人为本的关怀。
