Semple Cherith J, McCaughan Eilís, Beck Esther R, Hanna Jeffrey R
School of Nursing, Ulster University, Newtownabbey, Co. Antrim, UK.
South Eastern Health and Social Care Trust, Cancer Services, Ulster Hospital, Belfast, UK.
Palliat Med. 2021 May;35(5):933-942. doi: 10.1177/02692163211001719. Epub 2021 Mar 26.
When a parent of dependent children (<18 years old) is at end of life from cancer, this has a profound impact on the family. Children less prepared for the death of a parent are more susceptive to poorer psychosocial adjustment in later life. There is a lack of understanding from the literature surrounding what support parents require, and how they navigate this end of life experience.
To explore bereaved parents' experience and needs for families when a parent is at end of life from cancer with dependent children.
In-depth, semi-structured qualitative interviews were conducted with 21 bereaved mothers and fathers, identified from the general public, a family support service and hospice. Data were analysed thematically.
Parents often live in 'parallel worlds' throughout the end of life period. In one world, 'living in the moment', cherishing the ordinariness of family life, remaining hopeful treatment will prolong life, whilst adapting as the illness unfolds. The other world presents as 'intermitted glimpses that death is approaching', shadowed with painful emotional concerns surrounding their children and the future. At the end, death rapidly approaches, characterised as suddenly 'falling off the cliff'; placing significant demands on the well-parent.
Amidst challenges, clinicians should provide parents with clear information surrounding a poor prognosis, so families can plan and prepare for parental death. There is a need for healthcare professionals to engage, encourage and equip parents, as they prepare their children throughout the end of life experience for the inevitable death of a parent.
当有未成年子女(<18岁)的父母因癌症走到生命尽头时,这会对家庭产生深远影响。对父母死亡准备不足的孩子在日后生活中更易出现较差的心理社会适应情况。关于父母需要何种支持以及他们如何应对这种生命终结经历,现有文献缺乏相关理解。
探讨当有未成年子女的父母因癌症走到生命尽头时,丧亲父母的经历及家庭需求。
对从普通公众、家庭支持服务机构和临终关怀机构中识别出的21位丧亲父母(包括母亲和父亲)进行了深入的半结构化定性访谈。对数据进行了主题分析。
在整个生命终结阶段,父母常常生活在“平行世界”中。在一个世界里,“活在当下”,珍视家庭生活的平凡,仍抱有治疗能延长生命的希望,同时随着病情发展进行调整。另一个世界则呈现为“断断续续瞥见死亡临近”,笼罩着围绕子女和未来的痛苦情感担忧。最后,死亡迅速降临,其特征是突然“坠入悬崖”,这对未患病的一方提出了巨大要求。
在面临挑战时,临床医生应向父母提供关于预后不良的明确信息,以便家庭能够为父母的死亡进行规划和准备。在父母为子女准备应对父母不可避免的死亡而经历整个生命终结阶段时,医疗保健专业人员需要参与、鼓励并帮助父母。