南非西开普省临终关怀机构的精神关怀实践：多样性的挑战。
Spiritual care practices in hospices in the Western cape, South Africa: the challenge of diversity.
机构信息
Department of Psychology, Stellenbosch University, Private Bag X4, Matieland, Stellenbosch, 7745, South Africa.
Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7602, South Africa.
出版信息
BMC Palliat Care. 2021 Jan 10;20(1):9. doi: 10.1186/s12904-020-00704-z.
BACKGROUND
South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local issues and constraints.
METHODS
Two sets of focus group discussions, with 23 hospice participants, were conducted with 11 of the 12 Hospice Palliative Care Association registered hospices in the Western Cape, South Africa, to understand what spiritual care practices existed in their hospices against the backdrop of multifaceted diversities. The discussions were analysed using thematic analysis.
RESULTS
Two prominent themes emerged: the challenges of providing relevant spiritual care services in a religiously, culturally, linguistically and racially diverse setting, and the organisational context impacting such a spiritual care service. Participants agreed that spiritual care is an important service and that it plays a significant role within the inter-disciplinary team. Participants recognised the need for spiritual care training and skills development, alongside the financial costs of employing dedicated spiritual care workers. In spite of the diversities and resource constraints, the approach of individual hospices to providing spiritual care remained robust.
DISCUSSION
Given the diversities that are largely unique to South Africa, shaped essentially by past injustices, the hospices have to navigate considerable hurdles such as cultural differences, religious diversity, and language barriers to provide spiritual care services, within significant resource constraints.
CONCLUSIONS
While each of the hospices have established spiritual care services to varying degrees, there was an expressed need for training in spiritual care to develop a baseline guide that was bespoke to the complexities of the South African context. Part of this training needs to focus on the complexity of providing culturally appropriate services.
背景
南非是一个多元化的中等收入国家，其殖民和种族隔离历史的遗留问题仍使其社会严重分化。本文是一项更大规模研究的一部分，旨在探讨南非西开普省临终关怀机构代表在当地问题和限制的背景下，提供适当的精神关怀服务的经验和观点。
方法
在南非西开普省的 12 家临终关怀协会注册的 12 家临终关怀机构中，选择了 11 家机构进行了两组焦点小组讨论，共有 23 名临终关怀机构代表参加，以了解在宗教、文化、语言和种族多样化背景下，他们的临终关怀机构存在哪些精神关怀实践。使用主题分析对讨论进行分析。
结果
出现了两个突出的主题：在宗教、文化、语言和种族多样化的环境中提供相关精神关怀服务的挑战，以及影响这种精神关怀服务的组织背景。参与者一致认为精神关怀是一项重要的服务，在跨学科团队中发挥着重要作用。参与者认识到需要进行精神关怀培训和技能发展，以及雇佣专门的精神关怀工作者的经济成本。尽管存在多样性和资源限制，各个临终关怀机构提供精神关怀的方法仍然很坚定。
讨论
鉴于南非的多样性在很大程度上是由过去的不公正所导致的，具有独特性，临终关怀机构必须在资源有限的情况下，克服文化差异、宗教多样性和语言障碍等巨大障碍，提供精神关怀服务。
结论
虽然每个临终关怀机构都在不同程度上建立了精神关怀服务，但显然需要进行精神关怀培训，以制定一份符合南非复杂情况的专用基线指南。培训的一部分需要侧重于提供文化上适当的服务的复杂性。
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