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医生对临终患者的观念:英国医学文献的范围综述和定性内容分析。

Physicians' Conceptions of the Dying Patient: Scoping Review and Qualitative Content Analysis of the United Kingdom Medical Literature.

机构信息

Edinburgh Medical School, 523476The University of Edinburgh Edinburgh Medical School, Edinburgh, UK.

出版信息

Qual Health Res. 2022 Oct;32(12):1881-1896. doi: 10.1177/10497323221119939. Epub 2022 Aug 18.

Abstract

Most people in high income countries experience dying while receiving healthcare, yet dying has no clear beginning, and contexts influence how dying is conceptualised. This study investigates how UK physicians conceptualise the dying patient. We employed Scoping Study Methodology to obtain medical literature from 2006-2021, and Qualitative Content Analysis to analyse stated and implied meanings of language used, informed by social-materialism. Our findings indicate physicians do not conceive a dichotomous distinction between dying and not dying, but construct conceptions of the dying patient in subjective ways linked to their practice. We argue that the focus of future research should be on exploring practice-based challenges in the workplace to understanding patient dying. Furthermore, pre-Covid-19 literature related dying to chronic illness, but analysis of literature published since the pandemic generated conceptions of dying from acute illness. Researchers should note the ongoing effects of Covid-19 on societal and medical awareness of dying.

摘要

大多数高收入国家的人在接受医疗保健的过程中都会经历死亡,但死亡没有明确的开始,而且环境会影响对死亡的概念化。本研究调查了英国医生如何概念化临终患者。我们采用范围研究方法从 2006 年至 2021 年获取医学文献,并采用定性内容分析方法分析语言的陈述和隐含意义,这一方法受到社会唯物主义的启发。我们的研究结果表明,医生并没有将死亡和非死亡截然分开,而是以主观的方式构建临终患者的概念,这种主观方式与他们的实践有关。我们认为,未来研究的重点应该是探索工作场所中基于实践的挑战,以了解患者的死亡。此外,新冠疫情前的文献将死亡与慢性病联系起来,但对大流行后发表的文献的分析产生了对急性病死亡的概念化。研究人员应该注意到新冠疫情对社会和医学对死亡的认识的持续影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c64a/9511242/d05eda6c0659/10.1177_10497323221119939-fig1.jpg

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