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非正式照护者在晚期癌症患者姑息治疗中的作用、影响及支持:一项多国定性研究。

The role, impact, and support of informal caregivers in the delivery of palliative care for patients with advanced cancer: A multi-country qualitative study.

作者信息

Adejoh Samuel Ojima, Boele Florien, Akeju David, Dandadzi Adlight, Nabirye Elizabeth, Namisango Eve, Namukwaya Elizabeth, Ebenso Bassey, Nkhoma Kennedy, Allsop Matthew J

机构信息

Department of Social Work, University of Lagos, Lagos, Nigeria.

Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

出版信息

Palliat Med. 2021 Mar;35(3):552-562. doi: 10.1177/0269216320974925. Epub 2020 Dec 23.

Abstract

BACKGROUND

Cancer is increasing in its prevalence in sub-Saharan Africa. Informal caregivers are key to supporting engagement and interaction with palliative care services, but limited literature on their role impedes development of supportive interventions.

AIM

We aimed to understand the role, impact, and support of informal caregivers of patients with advanced cancer when interacting with palliative care services in Nigeria, Uganda, and Zimbabwe.

DESIGN

Secondary analysis of qualitative interview transcripts. The dataset was assessed for fit and relevance and framework approach was used.

SETTING/PARTICIPANTS: Interview transcripts of informal caregivers included participants aged over 18 years of age recruited from palliative care services across participating countries.

RESULTS

A total of 48 transcripts were analyzed. Mean age was 37 (range 19-75) with equal numbers of men and women. Five themes emerged from the data: (1) caregivers are coordinators of emotional, practical, and health service matters; (2) caregiving comes at a personal social and financial cost; (3) practical and emotional support received and required; (4) experience of interacting and liaising with palliative care services; and (5) barriers and recommendations relating to the involvement of palliative care.

CONCLUSIONS

The role of informal caregivers is multi-faceted, with participants reporting taking care of the majority of medical, physical, financial, and emotional needs of the care recipient, often in the face of sacrifices relating to employment, finances, and their own health and social life. Efforts to develop comprehensive cancer control plans in sub-Saharan Africa must take account of the increasing evidence of informal caregiver needs.

摘要

背景

癌症在撒哈拉以南非洲的患病率正在上升。非正式照护者是支持参与姑息治疗服务及互动的关键,但关于其作用的文献有限,这阻碍了支持性干预措施的发展。

目的

我们旨在了解尼日利亚、乌干达和津巴布韦晚期癌症患者的非正式照护者在与姑息治疗服务互动时的作用、影响和支持情况。

设计

对定性访谈记录进行二次分析。对数据集进行了适用性和相关性评估,并采用了框架法。

地点/参与者:非正式照护者的访谈记录包括从参与国的姑息治疗服务机构招募的18岁以上参与者。

结果

共分析了48份记录。平均年龄为37岁(范围19 - 75岁),男女数量相等。数据中出现了五个主题:(1)照护者是情感、实际和医疗服务事务的协调者;(2)照护带来个人社会和经济成本;(3)获得和需要的实际及情感支持;(4)与姑息治疗服务互动和联络的经历;(5)与姑息治疗参与相关的障碍和建议。

结论

非正式照护者的作用是多方面的,参与者报告称,他们通常要在牺牲就业、财务以及自身健康和社会生活的情况下,照顾受照护者的大部分医疗、身体、财务和情感需求。在撒哈拉以南非洲制定全面癌症控制计划的努力必须考虑到越来越多关于非正式照护者需求的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a55/7975852/dba947dd46d5/10.1177_0269216320974925-fig1.jpg

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