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“并非万灵药”——专家对复原力概念及其在姑息治疗中的潜力的看法。

'Not a panacea' - Expert perspectives on the concept of resilience and its potential for palliative care.

作者信息

Maus Katja, Peusquens Frank, Kriegsmann-Rabe Milena, Matthias Julia-Katharina, Ateş Gülay, Jaspers Birgit, Geiser Franziska, Radbruch Lukas

机构信息

Department of Palliative Medicine, University Hospital Bonn, Venusberg-Campus 1, Bonn 53127, Germany.

Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany.

出版信息

Palliat Care Soc Pract. 2024 May 27;18:26323524241254839. doi: 10.1177/26323524241254839. eCollection 2024.

Abstract

BACKGROUND

Resilience is an increasingly used term in medicine and subject to various definitions, often not easy to grasp. There are established core concepts for patients receiving palliative care, for example, meaning in life, that have already been researched a lot. Resilience, relative to these concepts, is a new object of research in palliative care, where it has so far been used predominantly with regard to the well-being of teams.

AIM

To explore how experts in palliative care define the concept of resilience and its suitability for patients, significant others, and professionals.

DESIGN

Qualitative study using summarizing content analysis according to Mayring.

SETTING/PARTICIPANTS: Twenty-one health and social care professionals with expertise caring for persons with life-threatening/limiting illnesses and their relatives were interviewed in three individual interviews and four focus groups. All conversations were recorded, transcribed, coded MAXQDA, and validated by another researcher.

RESULTS

Resilience has been described as something procedural, dynamic, individual, and flexible. In connection with well-known concepts such as posttraumatic growth or terms from the field of mindfulness, social environment or personal factors have also been linked to resilience. Resources such as spirituality can contribute to resilience, and resilience itself can function as a resource, for example, by contributing to quality of life. An active use of the term in practical work with patients or relatives is rare, but it is used in education or team measures. Limited lifespan can pose a challenge to an active use of the concept of resilience.

CONCLUSION

Resilience as a very individual approach provides added value to other core concepts of palliative care. Within the palliative context, the normative dimension of resilience must be well reflected. A broader definition of resilience is recommended, leaving room for everyone to find their own form of resilience. The concept of resilience in palliative care includes opportunities as well as risks and should, therefore, be implemented carefully, requiring specific training.

摘要

背景

复原力是医学中一个使用越来越频繁的术语,其定义多样,常常难以理解。对于接受姑息治疗的患者,已有一些既定的核心概念,比如生命意义,对此已进行了大量研究。相对于这些概念,复原力在姑息治疗中是一个新的研究对象,目前主要用于团队福祉方面。

目的

探讨姑息治疗专家如何界定复原力概念及其对患者、重要他人和专业人员的适用性。

设计

采用根据迈林方法进行的总结性内容分析的定性研究。

背景/参与者:对21名在照顾患有危及生命/受限疾病的患者及其亲属方面具有专业知识的卫生和社会护理专业人员进行了3次个人访谈和4次焦点小组访谈。所有对话均进行了录音、转录、使用MAXQDA编码,并由另一位研究人员进行了验证。

结果

复原力被描述为一种过程性、动态性、个体性和灵活性的东西。与创伤后成长等知名概念或正念领域的术语相关联时,社会环境或个人因素也与复原力有关。诸如灵性等资源可有助于复原力,而复原力本身也可作为一种资源发挥作用,例如通过提高生活质量。在与患者或亲属的实际工作中很少积极使用该术语,但在教育或团队措施中会使用。有限的寿命可能对积极应用复原力概念构成挑战。

结论

复原力作为一种非常个性化的方法,为姑息治疗的其他核心概念增添了价值。在姑息治疗背景下,必须充分反映复原力的规范层面。建议对复原力进行更广泛的定义,为每个人找到自己的复原形式留出空间。姑息治疗中的复原力概念既包含机遇也包含风险,因此应谨慎实施,需要进行特定培训。

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