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2019年《生命终结选择法案》在新西兰奥特亚罗瓦辅助死亡从业者中的早期经验。

Early experiences of the End of Life Choice Act 2019 amongst assisted dying practitioners in Aotearoa New Zealand.

作者信息

Dehkhoda Aida, Frey Rosemary, Carey Melissa, Robinson Jacqualine, Sundram Frederick, Hoeh Nicholas, Bull Susan, Cheung Gary

机构信息

University of Auckland, Auckland, New Zealand.

University of Southern Queensland, Queensland, Australia.

出版信息

BMC Palliat Care. 2025 May 24;24(1):149. doi: 10.1186/s12904-025-01747-w.

Abstract

BACKGROUND

The global trend of legalising assisted dying (AD) has reshaped end-of-life care practices, and Aotearoa New Zealand's adoption of the End of Life Choice Act (the Act) in 2019 represents a significant shift. Limited empirical research on AD in New Zealand after the enactment of the Act underscores the need for investigation. Conducting research in the early stages of AD implementation is crucial to building a strong knowledge base and laying the foundation for future research. This would ensure equitable and suitable service provision for the service users.

AIM

This research captured the experiences of health practitioners directly involved in providing AD under New Zealand's End of Life Choice Act 2019.

DESIGN

Using the "memorable case" approach, 22 participants reflected on the process of assessing, treating, and delivering AD services in the first 12 months of implementing the new AD law.

RESULTS

Thematic analysis identified four major themes underlying the experiences of assisted dying practitioners/providers (ADPs). The themes focused on three aspects of ADPs' experience: KNOWING: prior personal experience (personal beliefs, clinical background, and AD training) and reflective experiences of DOING assessments, service delivery, and patient/family experiences and BEING an ADP (personal, professional, emotional, and social impacts). Additionally, the themes highlighted the overarching influence of health system infrastructure, challenges, and resources that shaped ADPs' overall experience.

CONCLUSION

These findings contribute to new knowledge by uncovering gaps in understanding, competency, service implementation, and the emotional impact on ADPs. The findings could inform the development of an educational, supportive, and culturally safe program, including resources for workforce development.

摘要

背景

全球范围内辅助死亡合法化的趋势重塑了临终关怀实践,2019年新西兰(奥特亚罗瓦)通过《临终选择法案》(以下简称“该法案”)代表了一个重大转变。该法案颁布后,新西兰关于辅助死亡的实证研究有限,这凸显了进行调查的必要性。在辅助死亡实施的早期阶段开展研究对于建立强大的知识基础以及为未来研究奠定基础至关重要。这将确保为服务使用者提供公平且合适的服务。

目的

本研究记录了直接参与根据新西兰2019年《临终选择法案》提供辅助死亡服务的医疗从业者的经历。

设计

采用“难忘案例”方法,22名参与者回顾了在新辅助死亡法律实施的头12个月里评估、治疗和提供辅助死亡服务的过程。

结果

主题分析确定了辅助死亡从业者/提供者(ADPs)经历背后的四个主要主题。这些主题集中在ADPs经历的三个方面:认知:先前的个人经历(个人信仰、临床背景和辅助死亡培训)以及进行评估、服务提供、患者/家属经历的反思性经历,以及作为一名ADPs的状态(个人、职业、情感和社会影响)。此外,这些主题突出了卫生系统基础设施、挑战和资源的总体影响,这些因素塑造了ADPs的整体经历。

结论

这些发现通过揭示在理解、能力、服务实施以及对ADPs的情感影响方面的差距,为新知识做出了贡献。这些发现可为制定一个教育、支持和文化安全的项目提供参考,包括劳动力发展资源。

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