Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
Nurs Philos. 2021 Apr;22(2):e12334. doi: 10.1111/nup.12334. Epub 2020 Oct 22.
Palliative care is provided at a certain timepoint, both in a person's life and in a societal context. What is considered to be a good death can therefore vary over time depending on prevailing social values and norms, and the person's own view and interpretation of life. This means that there are many interpretations of what a good death can actually mean for an individual. On a more general level, research in palliative care shows that individuals have basic common needs, for example physical, mental, social and spiritual well-being. Therefore, in today's pluralistic Western society, it becomes important that palliative care is person centred to enable individuals to receive, as far as can be achieved, care that promotes as good a life as possible based on the person's own needs and preferences, and in accordance with evidence and current laws. For many years a research group, consisting nurse researchers together with nurses working in palliative care, has developed a model for person-centred palliative care, the 6S-model. The model's central concept is Self-image, where the starting point is the patient as a person and their own experience of the situation. The other concepts: Self-determination, Symptom relief, Social relationships, Synthesis and Strategies are all related to the patient's self-image, and often to each other. The model's development, value base and starting assumptions are reported here, as are examples of how the model is applied in palliative care in Sweden. The model has been, and still is, constantly evolving in a collaboration between researchers and clinically active nurses, and in recent years also with patients and close relatives.
姑息治疗是在一个人的生命和社会背景中的某个时间点提供的。因此,什么是好的死亡,可以随着时间的推移而变化,取决于当时流行的社会价值观和规范,以及个人对生活的看法和解释。这意味着,对于个人来说,好的死亡可能意味着许多不同的事情。在更广泛的层面上,姑息治疗研究表明,个人有基本的共同需求,例如身体、心理、社会和精神健康。因此,在当今多元化的西方社会中,姑息治疗以患者为中心变得非常重要,以使个人能够尽可能地获得基于自己的需求和偏好,以及符合证据和现行法律的,促进尽可能好的生活的护理。多年来,一个由护士研究人员和姑息治疗护士组成的研究小组,已经开发出了一个以患者为中心的姑息治疗模型,即 6S 模型。该模型的核心概念是自我形象,其起点是患者作为一个人和他们对自己处境的体验。其他概念:自我决定、症状缓解、社会关系、综合和策略,都与患者的自我形象有关,并且通常彼此相关。本文报告了该模型的发展、价值基础和起始假设,以及该模型在瑞典姑息治疗中的应用实例。该模型一直在不断发展,是研究人员和临床活跃护士之间的合作,近年来还与患者和亲属合作的结果。