"They Would Lift My Spirits": Sources of Support for Family Surrogate Decision-Makers at the End of Life.

IF 1.2 4区 医学 Q3 NURSING
Marlena C Fisher, Elaina Parrillo, Claire Petchler, Joan Kub, Mark T Hughes, Daniel P Sulmasy, Deborah Baker, Marie T Nolan
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引用次数: 0

Abstract

Surrogate decision-makers make critical decisions for loved ones at the end of life, and some experience lasting negative psychological outcomes. Understanding whom they rely on for support and the types of support they value may inform nursing care and that of other health team members who work with surrogates. The purpose of the study was to explore decision support and other types of support provided to surrogate decision-makers at the end of life of their loved one and perceived usefulness of the support. This secondary analysis of data from a mixed-methods study involved the examination of the transcripts of qualitative interviews with 13 surrogate decision-makers in the United States, conducted between 2010 and 2014. A constant comparative method was used to identify common themes surrounding surrogate decision support at the end of life. Surrogates valued advance directives and conversations with their loved one about treatment preferences. Surrogates described involving many different types of people in decision-making and other types of support. Finally, surrogates appreciated being reassured that they were doing a good job in making decisions and seemed to seek out this type of affirmation from various sources including the health care team, family, and friends. Nurses are well-positioned to provide this affirmation because of the time that they spend caring for the patient and family. Future research should further explore the concept of affirmation of surrogates in their role as a means of support as they make decisions for a loved one.

"他们会让我精神振奋":生命末期家庭代理决策者的支持来源。
代理决策者在生命末期要为所爱之人做出关键性决定,其中一些人会经历持久的负面心理影响。了解他们所依赖的支持对象以及他们所重视的支持类型可为护理工作以及与代理决策者合作的其他医疗团队成员的护理工作提供参考。本研究的目的是探讨在代理决策者的亲人临终时为其提供的决策支持和其他类型的支持,以及这些支持的有用性。本研究对一项混合方法研究的数据进行了二次分析,包括对 2010 年至 2014 年期间在美国对 13 位代理决策者进行的定性访谈记录进行检查。研究采用恒定比较法来确定生命末期代理决策支持的共同主题。代理决策者重视预先指示以及与亲人就治疗偏好进行的对话。代治者描述了让许多不同类型的人参与决策和其他类型支持的情况。最后,代治者希望得到他们的保证,即他们在做决定时做得很好,他们似乎从各种渠道寻求这种肯定,包括医疗团队、家人和朋友。护士有能力提供这种肯定,因为她们花了大量时间照顾病人和家属。未来的研究应进一步探讨肯定代理者角色的概念,以此作为他们为所爱之人做决定时的一种支持手段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.60
自引率
11.10%
发文量
203
审稿时长
6-12 weeks
期刊介绍: Journal of Hospice & Palliative Nursing (JHPN) is the official journal of the Hospice & Palliative Nurses Association and is the professional, peer-reviewed journal for nurses in hospice and palliative care settings. Focusing on the clinical, educational and research aspects of care, JHPN offers current and reliable information on end of life nursing. Feature articles in areas such as symptom management, ethics, and futility of care address holistic care across the continuum. Book and article reviews, clinical updates and case studies create a journal that meets the didactic and practical needs of the nurse caring for patients with serious illnesses in advanced stages.
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