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临终阶段非正规移民患者照顾者的尊严:一项定性研究。

Dignity of informal caregivers of migrant patients in the last phase of life: a qualitative study.

机构信息

Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.

Amsterdam Public Health Research Institute, Van Boechorstraat 7, Postbus 7057, 1007 MB, Amsterdam, Netherlands.

出版信息

BMC Palliat Care. 2021 Feb 4;20(1):26. doi: 10.1186/s12904-021-00721-6.

Abstract

BACKGROUND

A key aim of palliative care is to improve the quality of life of patients and their families. To help ensure quality of life for the families of patients with migrant backgrounds, this study sought insights into the dignity of informal caregivers in migrant communities. This could improve understanding of family-centered care for migrant patients.

METHODS

Twenty semi-structured interviews with informal caregivers of Turkish, Moroccan, or Surinamese background living in the Netherlands were analyzed thematically.

RESULTS

The dignity of the patient and that of their informal caregivers were found to be strongly interrelated. Most important for the dignity of caregivers was ensuring good care for their patients and preserving the patients' dignity. Ensuring good care involved advocating for good and dignified care and for satisfaction of a patient's wishes. For many informal caregivers, it also included delivering care to the patient by themselves or together with other family members, despite having to give up part of their own lives. Providing care themselves was part of maintaining a good relationship with the patient; the care was to cater to the patient's preferences and help preserve the patient's dignity, and it could be accompanied by valuable aspects such as times for good conversations. Positive interaction between an informal caregiver and a patient positively influenced the informal caregiver's dignity. Informal caregiver and patient dignity were often compromised simultaneously; when informal caregivers felt healthcare professionals were undermining a patient's dignity, their own dignity suffered. According to informal caregivers, healthcare professionals can help them preserve dignity by taking seriously their advice about the patient, keeping them informed about the prognosis of the disease and of the patient, and dealing respectfully with differences in values at the end of life.

CONCLUSION

The dignity of migrant patients' informal caregivers in the last phase of a patient's life is closely entwined with ensuring good care and dignity for the patient. Healthcare professionals can strengthen the dignity of informal caregivers by supporting their caregiving role.

摘要

背景

缓和医疗的一个主要目标是提高患者及其家属的生活质量。为了帮助确保有移民背景的患者家属的生活质量,本研究旨在深入了解移民群体中非正式照顾者的尊严。这有助于提高对移民患者以家庭为中心的护理的理解。

方法

对居住在荷兰的具有土耳其、摩洛哥或苏里南背景的 20 名非正式照顾者进行了 20 次半结构化访谈,并进行了主题分析。

结果

发现患者及其非正式照顾者的尊严密切相关。对照顾者尊严最重要的是确保为患者提供良好的护理并维护患者的尊严。确保良好的护理包括倡导为患者提供良好和有尊严的护理以及满足患者的意愿。对许多非正式照顾者而言,这还包括自己或与其他家庭成员一起为患者提供护理,尽管他们不得不放弃自己的部分生活。自己提供护理是与患者保持良好关系的一部分;护理要迎合患者的喜好并帮助维护患者的尊严,同时还可以伴随着有价值的方面,例如进行良好的对话。照顾者与患者之间的积极互动会对非正式照顾者的尊严产生积极影响。照顾者和患者的尊严往往同时受到损害;当非正式照顾者感到医护人员损害了患者的尊严时,他们自己的尊严也会受到损害。根据非正式照顾者的说法,医护人员可以认真听取他们对患者的建议、向他们通报疾病和患者的预后、并在生命末期尊重价值观的差异,从而帮助他们维护尊严。

结论

在患者生命的最后阶段,移民患者的非正式照顾者的尊严与确保为患者提供良好的护理和尊严密切相关。医护人员可以通过支持他们的照顾角色来增强非正式照顾者的尊严。

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本文引用的文献

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A dignified last phase of life for patients with a migration background: A qualitative study.
Palliat Med. 2020 Dec;34(10):1385-1392. doi: 10.1177/0269216320948708. Epub 2020 Sep 11.
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