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潜在器官捐献者家属的丧亲体验:一项定性纵向案例研究,阐明了家庭关怀的机会。

The bereavement experiences of families of potential organ donors: a qualitative longitudinal case study illuminating opportunities for family care.

机构信息

Department of Psychology, University of Canberra, Canberra, Australia.

Department of Nursing and Midwifery, University of Canberra, Canberra, Australia.

出版信息

Int J Qual Stud Health Well-being. 2023 Dec;18(1):2149100. doi: 10.1080/17482631.2022.2149100.

Abstract

OBJECTIVES

To illuminate opportunities for care in the context of deceased organ donation by exploring pre-existing family and healthcare professional characteristics, in-hospital experiences, and ongoing adjustment through the lenses of grief theory, systems theory, meaning-making, narrative, and organ donation literature.

METHOD

Qualitative longitudinal case studies explored individual and family change in five Australian families who had consented to Donation after Circulatory Determination of Death at a single centre. Participants attended semi-structured interviews at four, eight, and twelve months after the death.

FINDINGS

Family values, pre-existing relationships, and in-hospital experiences influenced first responses to their changed lives, understanding of the patient's death, and ongoing family adjustment. Novel behaviour that was conguent with family values was required at the hospital, especially if the patient had previously played a key role in family decision-making. This behaviour and emerging interactional patterns were drawn into family life over the first year of their bereavement.

RECOMMENDATIONS

Training that includes lenses introduced in this study will enable healthcare professionals to confidently respond to individual and family psychosocial needs.

CONCLUSION

The lenses of grief theory and systems thinking highlight opportunities for care tailored to the unique in-hospital context and needs that emerge in the months that follow.

摘要

目的

通过探索预先存在的家庭和医疗保健专业人员特征、住院期间的经历以及通过悲伤理论、系统理论、意义建构、叙事和器官捐赠文献的视角来探索正在进行的调整,阐明在已故器官捐赠背景下的护理机会。

方法

定性纵向案例研究探讨了在单个中心同意循环确定死亡后捐赠的五户澳大利亚家庭中个人和家庭的变化。参与者在死亡后四个、八个和十二个月参加了半结构化访谈。

发现

家庭价值观、预先存在的关系和住院期间的经历影响了他们对生活变化、对患者死亡的理解以及正在进行的家庭调整的最初反应。在医院需要与家庭价值观一致的新行为,特别是如果患者以前在家庭决策中发挥了关键作用。这种行为和新出现的相互作用模式在他们丧亲的第一年被纳入家庭生活。

建议

包括本研究中介绍的视角的培训将使医疗保健专业人员能够自信地满足个人和家庭的社会心理需求。

结论

悲伤理论和系统思维的视角突出了在独特的医院环境中以及在接下来的几个月中出现的护理机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5302/9731585/97bff977698c/ZQHW_A_2149100_F0001_OC.jpg

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