Bottorff J L, Steele R, Davies B, Garossino C, Porterfield P, Shaw M
School of Nursing, University of British Columbia, Vancouver, Canada.
J Palliat Care. 1998 Spring;14(1):7-17.
A fundamental principle of palliative care is the provision of patient-centred care, an approach explicitly based on the patient's perspective. Although much attention has been given to determining patients' preferences for involvement in medical decisions, choices related to personal and nursing care routines have been largely ignored in the literature. Data from participant observations of nurse-patient interactions involving 16 palliative care patients and their nurses as well as 10 in-depth open-ended interviews with patients were analyzed using grounded theory methods. Although the choices made by patients appeared uncomplicated on the surface, the context of unfamiliarity, uncertainty, and unpredictability in palliative care increased the underlying complexity of decision making. Through a process of deliberation and trade-offs, patients attempted to regain or maintain some balance in their lives. This process of striving for balance consisted of three overlapping phases: weighing things up, communicating choice, and living with one's choices.
姑息治疗的一项基本原则是提供以患者为中心的护理，这是一种明确基于患者视角的方法。尽管在确定患者参与医疗决策的偏好方面已给予了很多关注，但文献中很大程度上忽略了与个人及护理日常相关的选择。使用扎根理论方法分析了来自对16名姑息治疗患者及其护士的护患互动进行参与观察的数据，以及对患者进行的10次深入开放式访谈的数据。尽管患者做出的选择表面上看似简单，但姑息治疗中不熟悉、不确定和不可预测的背景增加了决策的潜在复杂性。通过深思熟虑和权衡的过程，患者试图在生活中重新获得或保持某种平衡。这种追求平衡的过程包括三个重叠的阶段：权衡利弊、传达选择以及接受自己的选择。
