Rebolledo-Sanhueza Jame, Aliaga-Castillo Verónica, Bascuñán-Rodríguez María Luz, Acuña-Rojas Julia, Kirsten-Toro Kurt, Briceño-González Rocío, Cornejo-Guerrero María Constanza, Huepe-Ortega Gabriela
Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Hospital Santiago Oriente Dr. Luis Tisné Brousse, Santiago, Chile.
Cad Saude Publica. 2024 Nov 22;40(10):e00171023. doi: 10.1590/0102-311XES171023. eCollection 2024.
Preparing for death should be an integral part of end-of-life care and a public health concern. The objective of this study was to describe the meanings and practices of preparing for the death of older adults at the end of life from the perspectives of primary health care teams, family members and primary caregivers. A qualitative study was carried out through focus groups and individual interviews with a sample of 99 individuals, 45 primary health care professionals and technicians, 30 caregivers and 16 family members. The results were organized in three dimensions: (1) meanings about death and implications for preparing for death, highlighting the pain of death, suffering relief, and mediation of religious beliefs; (2) the practices of preparation for death of older adults, including the difficulty of talking about death, the search for tranquility and funeral preferences as a form of preparation; and (3) practices of teams that accompany caregivers and families, including psychological and spiritual support during care and the possibility of closing home care cycles during grief. The controversy of preparing for death for study participants and the challenges of primary care to include it in palliative care are discussed. In conclusion, this study shows the importance of including preparation for death strategies in the end-of-life care setting in primary care to promote a good death as an integral part of a good life.
为死亡做准备应成为临终关怀的一个组成部分以及一个公共卫生问题。本研究的目的是从初级卫生保健团队、家庭成员和主要照料者的角度描述老年人临终前为死亡做准备的意义和做法。通过焦点小组和对99名个体（45名初级卫生保健专业人员和技术人员、30名照料者和16名家庭成员）的个体访谈开展了一项定性研究。结果分为三个维度：（1）关于死亡的意义及对为死亡做准备的影响，突出死亡的痛苦、痛苦缓解以及宗教信仰的调解作用；（2）老年人为死亡做准备的做法，包括谈论死亡的困难、寻求安宁以及将葬礼偏好作为一种准备形式；（3）陪伴照料者和家庭的团队的做法，包括护理期间的心理和精神支持以及在悲伤期间结束家庭护理周期的可能性。讨论了研究参与者对为死亡做准备的争议以及初级保健将其纳入姑息治疗的挑战。总之，本研究表明在初级保健的临终关怀环境中纳入为死亡做准备的策略对于促进善终作为美好生活的一个组成部分的重要性。
