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农村地区的居家临终准备——提供癌症姑息治疗的家庭照料者的经验

Preparing for home death in rural areas - the experience of family caregivers providing palliative cancer care.

作者信息

Breivik Elisabet, Ervik Bente, Kitzmüller Gabriele

机构信息

Department of Health and Care Sciences, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.

Department of Oncology, University Hospital of North Norway, Tromsø, Norway.

出版信息

Int J Circumpolar Health. 2025 Dec;84(1):2507443. doi: 10.1080/22423982.2025.2507443. Epub 2025 May 19.

Abstract

Palliative care policies worldwide support people's wishes to spend their final days at home with family caregivers playing a vital role. In Norway, 16% of the population lives in rural areas where palliative end-of-life care is especially challenging due to geographical barriers and limited access to healthcare resources. Research on rural family end-of-life care for people with cancer is sparse. Therefore, the purpose of this study was to investigate what resources are needed for rural family caregivers when providing end-of-life care and preparing for home death for a person with cancer. Thirteen semi-structured in-depth interviews with family caregivers in seven rural municipalities in Northern Norway were conducted from February to April 2023. The thematic analysis revealed three key themes supporting caregivers' resilience: end-of-life care and home death require available resources in family caregivers; the availability of reliable professional follow-up services for end-of-life care; support from family and social networks compensate for lacking healthcare resources. Holistic healthcare for rural populations should consider aspects like distance and cost while involving the entire family and their social network. Local palliative care beds and telehealth services should be available to support rural family caregivers.

摘要

全球姑息治疗政策支持人们希望在家中度过最后时光的愿望,家庭照护者在其中发挥着至关重要的作用。在挪威,16%的人口生活在农村地区,由于地理障碍和医疗资源获取有限,临终姑息治疗尤其具有挑战性。关于农村地区癌症患者家庭临终关怀的研究很少。因此,本研究的目的是调查农村家庭照护者在为癌症患者提供临终关怀和准备在家中离世时需要哪些资源。2023年2月至4月,对挪威北部七个农村自治市的家庭照护者进行了13次半结构化深入访谈。主题分析揭示了支持照护者恢复力的三个关键主题:临终关怀和在家中离世需要家庭照护者具备可用资源;临终关怀需要可靠的专业后续服务;家庭和社会网络的支持可弥补医疗资源的不足。农村人口的整体医疗保健应考虑距离和成本等因素,同时让整个家庭及其社会网络参与进来。应提供当地的姑息治疗床位和远程医疗服务,以支持农村家庭照护者。

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