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从非正式照护者的角度看临终关怀过渡期 - 运用罗德斯(2000)进化方法的概念分析。

Transitions during end-of-life care from the perspective of informal caregivers - A concept analysis using Rodgers' (2000) evolutionary approach.

机构信息

The School of Nursing and Midwifery, Trinity College, Dublin, Ireland.

St. Francis Hospice, Dublin, The School of Nursing and Midwifery, Trinity College, Dublin, Ireland.

出版信息

Eur J Oncol Nurs. 2021 Apr;51:101899. doi: 10.1016/j.ejon.2021.101899. Epub 2021 Jan 20.

Abstract

PURPOSE

To produce a conceptual and operational definition of transition, in the context of end-of-life care, as experienced by informal caregivers.

METHODS AND SAMPLE

The authors used Rodgers' (2000) concept analysis framework to examine this concept.

FINDINGS

Common themes emerged using Rodgers' (2000) inductive approach confirming transition for informal caregivers at the end of life as a process comprising the presence of trigger(s)/event(s), awareness, instability and engagement/learning while maintaining normality. There was also duration to this process that was often unknown and unpredictable. This concept analysis provides useful insight into understanding the complex dynamics of transition during this period. The primary antecedent of this concept, prompting transition, is a diagnosis of non-curative disease for the patient. In some cases, a gradual realisation rather than a formal diagnosis that the illness has progressed to a non-curative stage, can also be an antecedent.

CONCLUSION

Transition during end-of-life-care for informal caregivers can be a highly emotional time for this vulnerable cohort. Effective transitioning can ensure a stability and quality end-of-life outcomes, such as a peaceful death, as the awareness and learning that it brings, prompts planning actions for terminal care. Through recognising the findings of this concept analysis, deeper insight may be gained to support the provision of care, by nurses, to informal caregivers, prompting them towards effective transitions that foster the best interest of the patient.

摘要

目的

在临终关怀背景下,为非正式照护者经历的过渡,生成一个概念和操作定义。

方法和样本

作者使用了 Rodgers(2000)的概念分析框架来研究这个概念。

结果

使用 Rodgers(2000)的归纳方法,出现了一些共同的主题,确认了临终时非正式照护者的过渡是一个过程,包括触发因素/事件的存在、意识、不稳定和参与/学习,同时保持正常状态。这个过程也有一定的持续时间,往往是未知和不可预测的。这个概念分析为理解这一时期过渡的复杂动态提供了有用的见解。这个概念的主要前提,即过渡的触发因素,是患者被诊断为无法治愈的疾病。在某些情况下,疾病进展到无法治愈阶段的逐步认识,而不是正式诊断,也可以作为一个前提。

结论

对于非正式照护者来说,临终关怀期间的过渡可能是一个非常情绪化的时期。有效的过渡可以确保稳定和高质量的临终结局,如和平死亡,因为它带来的意识和学习,可以促使为终末期护理制定计划。通过认识到这个概念分析的结果,可以更深入地了解护士为非正式照护者提供的护理,促使他们进行有效的过渡,以促进患者的最佳利益。

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