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在投入生活的同时为死亡做准备:一份关于居家儿童姑息治疗、临终关怀及死后护理的叙事探究与病例报告

Preparing for Death While Investing in Life: A Narrative Inquiry and Case Report of Home-Based Paediatric Palliative, End-of-Life, and After-Death Care.

作者信息

Noyes Michelle, Delaney Angela, Lang Meagan, Maybury Mellissa, Moloney Susan, Bradford Natalie

机构信息

Department of Paediatrics, Gold Coast University Hospital, Southport, QLD 4215, Australia.

Paediatric Palliative Care Service, Queensland Children's Hospital, South Brisbane, QLD 4101, Australia.

出版信息

Children (Basel). 2023 Nov 2;10(11):1777. doi: 10.3390/children10111777.

Abstract

Paediatric palliative care is pivotal for addressing the complex needs of children with incurable diseases and their families. While home-based care offers a familiar and supportive environment, delivering comprehensive services in this context is challenging. The existing literature on home-based palliative care lacks detailed guidance for its organization and implementation. This qualitative narrative inquiry explores the organization and provision of home-based paediatric palliative care. Data were collected from healthcare practitioners using conversations, storytelling, and reflective journaling. Schwind's Narrative Reflective Process was applied to synthesize the data, resulting in an in-depth case description. The narrative approach illuminates the complexities of home-based paediatric palliative, end-of-life, and after-death care. Key findings encompass the importance of early-care coordination, interprofessional collaboration, effective symptom management, emotional and psychosocial support, and comprehensive end-of-life planning. Through the case study of the child patient, the challenges and strategies for providing holistic, family-centred care within the home environment are described. Practical insights gained from this report can inform the development and improvement of home-based palliative care programs, benefiting researchers, practitioners, and policymakers seeking to optimize care for children and families in similar contexts.

摘要

儿科姑息治疗对于满足患有不治之症的儿童及其家庭的复杂需求至关重要。虽然居家护理提供了一个熟悉且支持性的环境,但在此背景下提供全面服务具有挑战性。现有的关于居家姑息治疗的文献缺乏关于其组织和实施的详细指导。这项质性叙事探究探讨了居家儿科姑息治疗的组织和提供情况。通过对话、讲故事和撰写反思日记从医疗从业者那里收集数据。运用施温德的叙事反思过程对数据进行综合,得出了一份深入的案例描述。叙事方法阐明了居家儿科姑息治疗、临终关怀和死后护理的复杂性。主要发现包括早期护理协调、跨专业协作、有效症状管理、情感和心理社会支持以及全面临终规划的重要性。通过对儿童患者的案例研究,描述了在家庭环境中提供全面的、以家庭为中心的护理所面临的挑战和策略。本报告获得的实际见解可为居家姑息治疗项目的开发和改进提供参考,使寻求在类似背景下优化儿童及家庭护理的研究人员、从业者和政策制定者受益。

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