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对姑息治疗中感恩本质的思考:在重症中治愈,通过陪伴患者直至生命尽头获得职业肯定。

A reflection on the essence of gratitude in palliative care: healing in severe disease and professional affirmation through accompanying patients until the end.

作者信息

Arantzamendi María, Aparicio Maria, Centeno Carlos, Sánchez-Migallón Sergio, Riojas Mariana, De Julián Victoria, Crespo Mariano

机构信息

ATLANTES Global Observatory of Palliative Care, Institute for Culture and Society, Universidad de Navarra, Edificio Ismael Sánchez Bella, 31009 Pamplona, Spain.

IdISNA-Instituto de Investigación Sanitaria de Navarra, Medicina Paliativa, Pamplona, Spain.

出版信息

Palliat Care Soc Pract. 2023 Jan 12;17:26323524221147538. doi: 10.1177/26323524221147538. eCollection 2023.

Abstract

BACKGROUND

Gratitude has sparked interest in the world of health. It is considered as a personality characteristic or as an emotion. However, little has been explored in the context of the interpersonal relationship of caring. An exploration in the context of end of life is ground-breaking.

OBJECTIVES

This study analyses and reflects on the object of gratitude from the perspective of both the persons being cared for and the professionals providing health care. What are patients and their family members grateful for in palliative care? What is the reason for gratitude? What do these health professionals perceive when there is gratitude? These questions were answered considering the gratitude generated in health care encounters, not gratitude as personality trait.

METHODS

The phenomenological approach was used starting from lived clinical experiences. In the light of the dialogue between clinical experiences and philosophy, this study proposes an explanation of the 'real' or essential object of gratitude in palliative care. It was conducted within the context of palliative care. The study materials were manifestations of gratitude expressed or felt in clinical encounters and published in newspapers or shared in daily encounters. These were the basis for analysis and reflection and interdisciplinary dialogue.

FINDINGS

The analyses performed indicated healing or deep relief in serious diseases as objects of gratitude according to patients' perspective, and professional self-affirmation until the end according to the professionals' perspective.

CONCLUSION

The two perspectives shared an important common fact, namely, the need to consider the persons in their entirety, and the importance of not losing sight of the value they have. This concept would characterize the nature of gratitude, its object being the 'objective good' for patients, family members, and palliative care professionals.

摘要

背景

感恩在健康领域引发了人们的兴趣。它被视为一种人格特质或一种情感。然而,在关怀的人际关系背景下,这方面的探索还很少。在临终关怀背景下进行探索具有开创性意义。

目的

本研究从被照顾者和提供医疗保健的专业人员两个角度分析并反思感恩的对象。在姑息治疗中,患者及其家属感恩的是什么?感恩的原因是什么?当出现感恩之情时,这些医疗专业人员察觉到了什么?回答这些问题时考虑的是医疗保健过程中产生的感恩之情,而非作为人格特质的感恩。

方法

从实际临床经验出发采用现象学方法。鉴于临床经验与哲学之间的对话,本研究对姑息治疗中感恩的“真实”或本质对象提出一种解释。研究在姑息治疗背景下开展。研究材料是在临床接触中表达或感受到的感恩表现,这些表现发表在报纸上或在日常接触中分享。这些是分析、反思和跨学科对话的基础。

研究结果

根据患者的观点,分析表明严重疾病中的治愈或深度缓解是感恩的对象;根据专业人员的观点,则是直至最后一刻的职业自我肯定。

结论

这两个观点有一个重要的共同事实,即需要全面考虑人,以及不能忽视他们所具有的价值的重要性。这一概念将表征感恩的本质,其对象是对患者、家属和姑息治疗专业人员而言的“客观益处”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c41/9841837/7fbb2bb12d1a/10.1177_26323524221147538-fig2.jpg

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