Huang Deqin, Huang Haishan, Mao Jing, Zeng Tieying
School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Neurology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
J Palliat Med. 2022 Sep;25(9):1431-1439. doi: 10.1089/jpm.2021.0570. Epub 2022 Jun 10.
Currently, the definition and naming of reflexive hospice care (RHC) vary, hindering its correct application in hospice care. The study aims to understand the meaning of RHC by clarifying its uses, attributes, antecedents, and consequences. The study focused on concept analysis. Walker and Avant's model was adopted for concept analysis, with a review based on PRISMA principles. RHC included three attributes: supporting a person verbally, actionally, spiritually, materially, and/or through actions; providing reverse care (from patient to his/her relatives, friends, and/or care team); and a two-way flow of love. Its antecedents were terminal patients' knowledge, affection, and intention for RHC, strong emotional connection between patients and their family members, and medical staff's knowledge and skills of RHC. Its consequences benefit the patients and their family members, medical staff, and society. RHC could improve patients' quality of life, alleviate the anxiety and depression of their family members, and deepen society's cognition of life and death. There is an urgent need to develop strategies, assessment tools, and courses for RHC to promote its application. Terminally ill patients who provide RHC will have better quality-of-life outcomes and face death more peacefully. Identifying the concept of RHC can help nurses and other health care professionals who wish to serve patients and their families better in hospice care.
目前，反射性临终关怀（RHC）的定义和命名各不相同，这阻碍了其在临终关怀中的正确应用。本研究旨在通过阐明RHC的用途、属性、前因和后果来理解其含义。该研究聚焦于概念分析。采用沃克和阿凡特的模型进行概念分析，并基于PRISMA原则进行综述。RHC包括三个属性：在言语、行动、精神、物质方面和/或通过行动支持一个人；提供反向关怀（从患者到其亲属、朋友和/或护理团队）；以及爱的双向流动。其前因包括晚期患者对RHC的认知、情感和意愿，患者与其家庭成员之间强烈的情感联系，以及医护人员对RHC的知识和技能。其后果有益于患者及其家庭成员、医护人员和社会。RHC可以提高患者的生活质量，减轻其家庭成员的焦虑和抑郁，并加深社会对生死的认知。迫切需要为RHC制定策略、评估工具和课程，以促进其应用。提供RHC的晚期患者将有更好的生活质量结果，更平静地面对死亡。明确RHC的概念有助于护士和其他希望在临终关怀中更好地服务患者及其家属的医护专业人员。
