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理解有依赖子女的晚期癌症父母的临终关切:一项现象学研究。

Understanding Dying Concerns in Parents With Advanced Cancer With Dependent Children for Their Coparent: A Phenomenological Study.

出版信息

J Hosp Palliat Nurs. 2023 Oct 1;25(5):255-262. doi: 10.1097/NJH.0000000000000956. Epub 2023 Jun 10.

Abstract

Parents with advanced cancer and their dependent children experience high psychological distress, decreased quality of life, and decreased family functioning due to cancer-related concerns. Dying concerns are defined as fluctuating thoughts or feelings that are conscious or unconscious about an anticipated and approaching death that is attributed to a palliative/terminal diagnosis. This study used Gadamer's phenomenological approach to gain a shared understanding of the perspectives of the parents with advanced cancer about dying concerns, family life before and after advanced cancer diagnosis, and family resources to manage the crisis of advanced cancer for the coparent. The sample consisted of 4 patients from a Midwestern cancer hospital. Data were collected through 2 virtual semistructured interviews and were qualitatively analyzed using the hermeneutic rule and the theoretical concepts from McCubbin and McCubbin's Family Resiliency Model. Four major themes emerged: "Uncertainty in End-of-Life Decisions," "Effectless Communication," "Parental Skepticism," and "Psychological Well-being." The results showed that parents with advanced cancer have concerns for their coparent outside their parental role. Understanding dying concerns from all family members may increase nurse-initiated communication to improve family outcomes.

摘要

患有晚期癌症的父母及其依赖子女会因癌症相关问题而经历高度心理困扰、生活质量下降和家庭功能下降。临终关切是指对预期和即将到来的死亡的有意识或无意识的波动的想法或感受,归因于姑息/终末期诊断。本研究采用伽达默尔的现象学方法,从父母的角度获得对临终关切、癌症诊断前后的家庭生活以及管理癌症晚期危机的家庭资源的共同理解。样本由中西部癌症医院的 4 名患者组成。通过 2 次虚拟半结构化访谈收集数据,并使用解释学规则和 McCubbin 和 McCubbin 的家庭适应力模型的理论概念进行定性分析。出现了四个主要主题:“生命末期决策的不确定性”、“无效沟通”、“父母的怀疑”和“心理幸福感”。结果表明,患有晚期癌症的父母对其伴侣在父母角色之外的担忧。了解所有家庭成员的临终关切,可能会增加护士发起的沟通,以改善家庭结局。

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