Taylor E J, Ferrell B R, Grant M, Cheyney L
Loma Linda University, CA.
Oncol Nurs Forum. 1993 Jul;20(6):919-27.
The purpose of this paper is to present findings from an exploratory, descriptive study that investigated the experience of managing pain in the home from the perspectives of the patient, the primary family caregiver, and the homecare nurse. In particular, the decisions and ethical conflicts encountered by members of 10 patient-caregiver-nurse triads were studied. Data were collected through in-depth semistructured interviews, and the transcribed interviews were content-analyzed by a multidisciplinary research team. Subjects reported that the use of medications prompted the majority of the decisions and provoked most of the conflicts; however, decisions related to assessment, the future, and how to live with pain were identified as well. Subjects also identified other areas that created conflict, such as spiritual/theological issues, when to tell the truth, and interpersonal relationships. Findings illustrate the importance of understanding the beliefs and values that influence individuals' decisions and conflicts, because discrepant perceptions of the pain experience among patients, caregivers, and nurses can interfere with satisfactory management of pain.
本文的目的是呈现一项探索性描述性研究的结果，该研究从患者、主要家庭照顾者和家庭护理护士的角度调查了在家中管理疼痛的经历。具体而言，对10个患者 - 照顾者 - 护士三元组的成员所遇到的决策和伦理冲突进行了研究。通过深入的半结构化访谈收集数据，多学科研究团队对转录的访谈进行了内容分析。受试者报告称，药物的使用引发了大多数决策并引发了大部分冲突；然而，与评估、未来以及如何与疼痛共处相关的决策也被识别出来。受试者还指出了其他产生冲突的领域，如精神/神学问题、何时告知真相以及人际关系。研究结果表明理解影响个人决策和冲突的信念和价值观的重要性，因为患者、照顾者和护士对疼痛经历的不同认知可能会干扰疼痛的满意管理。
