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无偿护理者的心声:获取姑息治疗以及自我护理信息、资源和服务方面的问题与前景

Voices of unpaid carers: problems and prospects in accessing palliative care and self-care information, resources and services.

作者信息

Van Dinther Kristine, Javanparast Sara

机构信息

Research Centre for Palliative Care, Death and Dying, Flinders University, Bedford Park, GPO Box 2100, Adelaide, SA 5001, Australia.

Research Centre for Palliative Care, Death and Dying, Flinders University, Adelaide, SA, Australia.

出版信息

Palliat Care Soc Pract. 2024 May 29;18:26323524241255386. doi: 10.1177/26323524241255386. eCollection 2024.

Abstract

BACKGROUND

Unpaid carers make a substantial contribution to the health economy and carers of palliative patients are particularly vulnerable due to special patient needs and excessive carer burden. The Australian Government recently implemented the Integrated Carer Support Service Model to provide a range of free services to carers in the community. However, it is unclear whether such initiatives are effective and, more importantly, how carers of palliative patients gain access to information, support and services for the patient and themselves.

OBJECTIVES

We sought to investigate unpaid carers' experiences in accessing information and resources for support with patient care with a specific focus on palliative care resources and to determine carers' access to information and support for self-care. We also aimed to identify what opportunities and challenges remain for these particular carers according to their experiences.

METHODS

We conducted 18 semi-structured interviews and 3 focus groups with unpaid family or friend carers of palliative patients in South Australia from metropolitan, regional and rural communities. Grounded in a descriptive phenomenological paradigm, we conducted a hybrid approach to thematic analysis combining deductive and inductive coding following Fereday and Muir-Cochrane's method.

RESULTS

The government's web-based initiative provided little impact in supporting carers from our cohort. There remains a substantial gap between the formal recognition of the importance of carers and their lived reality. This recognition by health professionals is vital, as carer self-identification is not common and affects help-seeking behaviour. Carers seek and respond to more grassroots, personalized forms of support and sharing of information.

CONCLUSION

The lack of self-identification affects carers' help-seeking behaviours. Carer identification and recognition need to be initiated by health professionals in a proactive manner to ensure carers are prepared for their role and are emotionally supported to sustain it. Carers seek face-to-face guidance and sources of information.

摘要

背景

无偿护理人员对健康经济做出了重大贡献,而姑息治疗患者的护理人员由于患者的特殊需求和过重的护理负担,尤其脆弱。澳大利亚政府最近实施了综合护理支持服务模式,为社区中的护理人员提供一系列免费服务。然而,尚不清楚此类举措是否有效,更重要的是,姑息治疗患者的护理人员如何获取有关患者及自身的信息、支持和服务。

目的

我们试图调查无偿护理人员在获取患者护理支持信息和资源方面的经历,特别关注姑息治疗资源,并确定护理人员获取自我护理信息和支持的情况。我们还旨在根据这些护理人员的经历,确定他们面临的机遇和挑战。

方法

我们对南澳大利亚州大都市、地区和农村社区的18名姑息治疗患者的无偿家庭或朋友护理人员进行了半结构化访谈,并开展了3次焦点小组讨论。基于描述性现象学范式,我们采用混合方法进行主题分析,按照费雷迪和缪尔 - Cochrane的方法结合演绎和归纳编码。

结果

政府基于网络的举措对我们研究队列中的护理人员支持作用甚微。护理人员重要性的正式认可与他们的实际生活状况之间仍存在巨大差距。卫生专业人员的这种认可至关重要,因为护理人员自我认同并不常见,且会影响求助行为。护理人员寻求并回应更基层、个性化的支持和信息分享形式。

结论

缺乏自我认同会影响护理人员的求助行为。卫生专业人员需要积极主动地进行护理人员识别和认可,以确保护理人员为其角色做好准备,并在情感上得到支持以维持该角色。护理人员寻求面对面的指导和信息来源。

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