Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.
Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile.
J Adv Nurs. 2021 Jul;77(7):3132-3141. doi: 10.1111/jan.14836. Epub 2021 Mar 23.
To understand how the social patterns about death influence end-of-life care from the perspective of healthcare professionals.
A qualitative study according to the theory of Glaser and Strauss.
A purposeful sample of 47 participants with different roles (nurses, physicians and clinical psychologists) were involved in four focus groups and 17 interviews in 2017-2019. Responses were audio-recorded, transcribed verbatim and analysed using computer-assisted qualitative data.
A core category 'the theory of social patterns about death' emerged, which is explained by three categories: the culture of concealment and stubbornness towards death, the effort and internal work to make death a part of existence, and the influence of the social patterns of coping with death on end-of life care and healthcare professionals. Our results suggest that social coping with death is affected by a network of concealment and obstinacy towards death.
Recognizing death as part of life and thinking about death itself are social coping strategies. Although healthcare professionals occupy a privileged place in this process, the culture of concealment of death influences end-of-life care.
The social process that leads to the loneliness of the dying in our days has been theorized. However, social acceptance of death also influences healthcare professionals' attitudes towards death. Thus, healthcare professionals' own attitudes may affect the end-of-life care given to dying individuals and their families. The social patterns of death may contribute to the healthcare professionals' negative attitudes towards death. The concept of dignified death has been linked to the notion of humanization of healthcare. Death should be approached from a more naturalistic perspective by healthcare professionals, healthcare and academic institutions.
从医护专业人员的角度理解社会死亡观如何影响临终关怀。
根据格拉斯和施特劳斯的理论进行的定性研究。
2017 年至 2019 年，我们选取了具有不同角色（护士、医生和临床心理学家）的 47 名参与者，共进行了 4 个焦点小组和 17 次访谈。参与者的回答被录音、逐字转录，并使用计算机辅助定性数据分析进行分析。
出现了一个核心类别“社会死亡观理论”，由三个类别解释：对死亡的隐瞒和固执的文化、使死亡成为存在一部分的努力和内在工作，以及应对死亡的社会模式对临终关怀和医护专业人员的影响。我们的研究结果表明，社会对死亡的应对受到对死亡的隐瞒和固执的网络影响。
将死亡视为生命的一部分并思考死亡本身是社会应对策略。尽管医护专业人员在这个过程中占据了有利地位，但对死亡的隐瞒文化影响了临终关怀。
已经对导致当今临终者孤独的社会过程进行了理论化。然而，对死亡的社会接受也影响了医护专业人员对死亡的态度。因此，医护专业人员自己的态度可能会影响临终者及其家属所接受的临终关怀。死亡的社会模式可能导致医护专业人员对死亡的消极态度。有尊严的死亡的概念与医疗保健人性化的概念相关联。医护专业人员、医疗保健和学术机构应从更自然主义的角度看待死亡。
