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“争分夺秒,追求卓越”:临终关怀低收入移民癌症患者的扎根理论研究。

"Achieve the best while rushing against time": A grounded theory study on caring for low-income immigrant cancer patients at end of life.

机构信息

Palliative Care Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.

Department of Rehabilitation, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.

出版信息

Palliat Med. 2021 Feb;35(2):426-436. doi: 10.1177/0269216320974275. Epub 2020 Dec 25.

Abstract

BACKGROUND

Between 2000 and 2020, Europe experienced an annual net arrival of approximately 1.6 million immigrants per year. While having lower mortality rates, in the setting of severe diseases, immigrants bear a greater cancer-related burden due to linguistic and cultural barriers and socio-economic conditions. Professionals face a two-fold task: managing clinical conditions while considering the social, economic, cultural, and spiritual sphere of patients and their families. In this regard, little is known about the care provision to low-income immigrant cancer patients in real contexts.

AIM

To investigate the perspective of professionals, family members, and stakeholders on the caring process of low-income immigrant cancer patients at the end of life.

DESIGN

A Constructivist Grounded Theory study.

SETTING/PARTICIPANTS: The study, conducted at a Hospital in Northern Italy, involved 27 participants among health professionals, family caregivers, and other stakeholders who had recently accompanied immigrant cancer patients in their terminal phase of illness.

RESULTS

Findings evidenced that professionals feel they were not adequately trained to cope with immigrant cancer patients, nonetheless, they were highly committed in providing the best care they could, rushing against the (short) time the patients have left. Analyses evidenced four main categories: "providing and receiving hospitality," "understanding each other," "addressing diversity," and "around the patient," which we conceptualized under the core category "Achieve the best while rushing against time."

CONCLUSIONS

The model reveals the activation of empathic and compassionate behavior by professionals. It evidences the need for empowering professionals with cultural competencies by employing interpreters and specific training programs.

摘要

背景

在 2000 年至 2020 年期间,欧洲每年净接收移民约 160 万。尽管移民的死亡率较低,但在严重疾病的情况下,由于语言和文化障碍以及社会经济条件,他们承受着更大的癌症相关负担。专业人员面临着双重任务:管理临床情况,同时考虑患者及其家属的社会、经济、文化和精神领域。在这方面,人们对低收入移民癌症患者在实际情况下的护理提供情况知之甚少。

目的

调查专业人员、家庭成员和利益相关者对低收入移民癌症患者临终关怀过程的看法。

设计

建构主义扎根理论研究。

地点/参与者:该研究在意大利北部的一家医院进行,涉及 27 名参与者,包括卫生专业人员、家庭照顾者和其他利益相关者,他们最近在移民癌症患者生命的终末期陪伴他们。

结果

研究结果表明,专业人员认为他们没有接受过足够的培训来应对移民癌症患者,但他们非常致力于提供他们所能提供的最佳护理,与患者所剩的(短暂)时间赛跑。分析表明有四个主要类别:“提供和接受款待”、“相互理解”、“解决多样性”和“围绕患者”,我们将这些类别概念化为“在争分夺秒的同时尽力而为”的核心类别之下。

结论

该模型揭示了专业人员表现出的同理心和同情心行为。它表明需要通过雇用口译员和特定的培训计划,为专业人员提供文化能力赋权。

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