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巴勒斯坦被占领土上儿童不治之症家庭照顾者的经历:一项定性研究

The experience of family carers of children with incurable cancer: a qualitative study from the occupied Palestinian territory.

作者信息

Atout Maha, Alrimawi Intima, Abu Salameh Eman

机构信息

Faculty of Nursing, Philadelphia University, Amman, Jordan.

School of Nursing and Health Professions, Trinity Washington University, DC, USAxs.

出版信息

Lancet. 2021 Jul;398 Suppl 1:S16. doi: 10.1016/S0140-6736(21)01502-6.

Abstract

BACKGROUND

Treatments for childhood cancers have raised the survival rate, however different forms of malignancy continue to cause untimely deaths, and cancer remains a leading cause of death among children. Global research on paediatric cancer is limited for several reasons. Most research has focused on specific methodologies, including questionnaires with heterogeneous samples. In addition, many studies have covered a broad range of cancer diagnoses, and a wide range of children's ages and periods between diagnosis and treatment. These methods are unable to capture the essence of experiences and cultural differences. This study aimed to explore the experience of family carers of children with incurable cancer in occupied Palestinian territory.

METHODS

The study was conducted in the Paediatric Cancer Department of Beit Jala Hospital, which is the first public cancer department for children in the West Bank. The family carers of children aged 1-18 years with any type of incurable cancer in this hospital were considered eligible for participation, and the individual most involved in the care of the child was selected. To recruit participants, head nurses of medical and surgical paediatric floors provided assistance in approaching the carers of eligible children. The main objectives of the study were then discussed with the family carers. Semi-structured interviews were conducted with participants, and an interpretative phenomenological analysis approach was used to analyse the collected information. Ethical approval was obtained from the Beit Jala Hospital ethical review board and written informed consent was obtained from all participants.

FINDINGS

14 interviews were conducted. Participants were nine mothers, four grandmothers, and one father. Family carers discussed their caring experiences, including their experiences in administering special treatments, their suffering due to treating irritable children, and the information given to them about their children's illness. Family carers reported that they changed the focus of their care from an initial emphasis on normalising their children's lives to relieving their physical and psychological discomfort. This change of focus accompanied changes in carers' understanding of their child's disease over time. As carers became more realistic regarding the future of their children, they attempted to make their lives as comfortable as possible. Finally, carers discussed the support system around them; they found several resources to support them in the care of their children, including the experiences of other parents of children with similar diseases, the hospital environment, and their religious beliefs. Nevertheless, they stated that they needed more support during this difficult time of their lives.

INTERPRETATION

There is a need to support parents of children with incurable cancer in the occupied Palestinian territory. Suggestions to improve the quality of care provided for these parents include the education and recruitment of health care professionals, including social workers and psychologists, to provide emotional and spiritual support.

FUNDING

None.

摘要

背景

儿童癌症的治疗提高了生存率,然而不同形式的恶性肿瘤仍导致过早死亡,癌症仍是儿童死亡的主要原因之一。全球范围内针对儿童癌症的研究因多种原因受到限制。大多数研究集中在特定方法上,包括对异质样本进行问卷调查。此外,许多研究涵盖了广泛的癌症诊断类型、儿童年龄范围以及诊断与治疗之间的时间段。这些方法无法捕捉经验的本质和文化差异。本研究旨在探索巴勒斯坦被占领土上患有不治之症的儿童的家庭照料者的经历。

方法

该研究在拜特贾拉医院儿科癌症科进行,这是约旦河西岸首个为儿童设立的公共癌症科室。该医院中年龄在1至18岁、患有任何类型不治之症的儿童的家庭照料者被认为符合参与条件,并选取其中最主要参与孩子照料的个体。为招募参与者,儿科内科和外科楼层的护士长协助联系符合条件的儿童的照料者。随后与家庭照料者讨论了研究的主要目标。对参与者进行了半结构化访谈,并采用解释现象学分析方法分析所收集的信息。获得了拜特贾拉医院伦理审查委员会的伦理批准,并获得了所有参与者的书面知情同意。

结果

进行了14次访谈。参与者包括9位母亲、4位祖母和1位父亲。家庭照料者讲述了他们的照料经历,包括给予特殊治疗的经历、因照料烦躁的孩子而遭受的痛苦以及他们所获得的关于孩子病情的信息。家庭照料者报告称,他们将照料重点从最初强调让孩子的生活正常化转变为缓解孩子的身心不适。这种重点的转变伴随着照料者对孩子疾病的理解随时间的变化。随着照料者对孩子未来的看法变得更加现实,他们试图让孩子的生活尽可能舒适。最后,照料者讨论了他们周围的支持系统;他们找到了多种资源来支持他们照料孩子,包括其他患有类似疾病孩子的父母的经验、医院环境以及他们的宗教信仰。然而,他们表示在人生的这段艰难时期需要更多支持。

解读

在巴勒斯坦被占领土,需要为患有不治之症的儿童的父母提供支持。提高为这些父母提供的护理质量的建议包括教育和招募医疗保健专业人员,包括社会工作者和心理学家,以提供情感和精神支持。

资金

无。

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