Andersen Helle Elisabeth, Hoeck Bente, Nielsen Dorthe Susanne, Ryg Jesper, Delmar Charlotte
Department of Public Health, Nursing, Aarhus University, Aarhus, Denmark.
Health Sciences Research Centre, UCL, Odense, Denmark.
Int J Older People Nurs. 2020 Dec;15(4):e12335. doi: 10.1111/opn.12335. Epub 2020 Jul 27.
To describe lifeworld insights into the phenomenon of caring responsibility from the perspectives of persons aged 80+ years living alone with chronic illness, physical frailty and dependency on adult children.
A phenomenological inquiry inspired by Reflective Lifeworld Research.
Semi-structured lifeworld interviews with 11 persons aged 80+ years were conducted following their discharge. The interviews lasted 35-83 min, were audio-recorded and transcribed verbatim. Both interviews and the analysis followed the epistemological and methodological principles of Reflective Lifeworld Research.
We identified the essential meaning 'It means everything' and four constituents illuminating different aspects inherent in the complex phenomenon of caring responsibility; 'A life-constraining transition,' 'Trusting the children to fill the gaps and be the glue,' 'Tacit responsibility, agreement and acceptance' and 'Depending on the children and knowing they are burdened by you.'
Caring responsibility is based on a trusting relationship and tacit agreements indicating an understanding of interdependence and acceptance of dependence on adult children. However, a paradox appears when older persons express a deep-rooted perception of autonomy and independence as they have difficulties with their growing dependency and feelings of being burdensome. Older persons try to balance the continuum of autonomy, their existential self-image and actual capability. The practical part of caring responsibility seems to dominate and strongly affect the parent-child relationship because the child needs to take care of practical issues related to healthcare management and instrumental activities of daily living, leaving less time for meaningful togetherness.
Older persons want their adult children to be involved and acknowledged when planning care and treatment because they often seem to serve as the 'glue' that makes it possible for the parent to remain in his/her own home.
从80岁及以上独自生活、患有慢性病、身体虚弱且依赖成年子女的老年人的视角,描述对护理责任现象的生活世界洞察。
一项受反思性生活世界研究启发的现象学探究。
在11名80岁及以上的老年人出院后,对他们进行了半结构化的生活世界访谈。访谈持续35 - 83分钟,进行了录音并逐字转录。访谈和分析均遵循反思性生活世界研究的认识论和方法论原则。
我们确定了核心意义“这意味着一切”以及四个要素,这些要素阐明了护理责任这一复杂现象中固有的不同方面;“生活受限的转变”“信任子女填补空缺并成为维系纽带”“默契的责任、认同与接受”以及“依赖子女并知晓他们因你而负担沉重”。
护理责任基于信任关系和默契的约定,这表明对相互依存的理解以及对依赖成年子女的接受。然而,当老年人在面对日益增加的依赖性和成为负担的感觉时,表达出对自主性和独立性的根深蒂固的认知,就会出现一种矛盾。老年人试图在自主性的连续统、他们的存在自我形象和实际能力之间取得平衡。护理责任的实际部分似乎占据主导并强烈影响亲子关系,因为子女需要处理与医疗保健管理和日常生活工具性活动相关的实际问题,从而减少了有意义相处的时间。
老年人希望他们的成年子女在规划护理和治疗时参与其中并得到认可,因为他们往往似乎是使父母能够留在自己家中的“维系纽带”。