Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata, Rome, Italy - Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Universià degli Studi di Torino, Turin, Italy.
Ann Ist Super Sanita. 2020 Jul-Sep;56(3):315-324. doi: 10.4415/ANN_20_03_09.
Although family-centered communication about end-of-life care has been recognized to promote palliative-oriented care in nursing home (NH), how this communication may work is still unknown. Therefore, we explored the mechanisms by which end-of-life communication may contribute to palliative-oriented care in NH from the perspective of bereaved family carers.
A descriptive qualitative design was performed. Interviews were conducted with 32 bereaved family carers whose relative had died between 45 days to 9 months prior from 13 different NHs. A two-steps analysis process firstly with deductive and then with inductive content analysis was adopted.
Four mechanisms by which end-of-life communication contributed to palliative-oriented care were identified: a) promoting family carers understanding about their relative's health conditions, prognosis, and treatments available; b) fostering shared decision-making between healthcare professionals and residents/family carers; c) improving knowledge of residents' preferences; and d) improving knowledge of family carers' preferences.
Clear and in-depth communication provides insight into residents' and family carers' preferences for care and treatment at the end-of-life, and increases understanding and shared decision-making.
尽管以家庭为中心的临终关怀沟通已被认为可促进护理院（NH）的姑息治疗，但这种沟通如何发挥作用仍不清楚。因此，我们从丧亲的家庭照顾者的角度探讨了临终沟通如何有助于 NH 的姑息治疗。
采用描述性定性设计。对 32 名丧亲家庭照顾者进行了访谈，他们的亲属在从 13 家不同的 NH 死亡 45 天至 9 个月之前死亡。采用两步分析过程，首先是演绎式，然后是归纳式内容分析。
确定了临终沟通促进姑息治疗的四种机制：a）促进家庭照顾者了解其亲属的健康状况、预后和可用的治疗方法；b）促进医疗保健专业人员与居民/家庭照顾者之间的共同决策；c）提高对居民偏好的了解；d）提高对家庭照顾者偏好的了解。
清晰深入的沟通使人们了解居民和家庭照顾者在临终时对护理和治疗的偏好，并增进了理解和共同决策。
