澳大利亚维多利亚州自愿协助死亡对家庭成员和照顾者的悲伤和丧亲之痛的影响:定性研究

IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Camille La Brooy, Hayley Russell, Sophie Lewis, Paul Komesaroff
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引用次数: 0

摘要

在澳大利亚引入安乐死之前,很多人都反对安乐死,或者说反对自愿协助死亡,因为这可能会对家庭成员和照护者的悲伤和丧亲之痛产生不利影响。我们研究了正在经历、已经经历或正在考虑自愿协助死亡的家庭成员和照护者对自愿协助死亡的悲痛和丧亲之痛的新体验,并将有关悲痛和丧亲之痛的国际文献进行了对比。因此,我们在维多利亚州对家庭成员和照护者进行了 42 次半结构式访谈,维多利亚州是第一个立法支持自愿丧亡援助的司法管辖区。访谈围绕临终决策探讨了许多主题,以确定自愿丧亡援助是如何帮助或阻碍悲伤和丧亲过程的。我们使用 QSR NVivo 软件对访谈数据进行了主题分析。确定了四个关键主题:价值观和意义的创造、持续纽带的表达、预期的悲伤以及与支持经历 VAD 的亲人相关的护理负担。我们将这些主题与有关悲伤和丧亲之痛的重要文献并列在一起,以展示 VAD 如何给照护者带来新的挑战。我们认为,虽然 VAD 死亡与其他死亡具有相似的特征,但在某些方面,家庭成员和照护者的悲伤和丧亲结果是独一无二的。对于帮助亲人经历 VAD 的家庭成员和照护者来说,他们能够从满足亲人的愿望和努力让亲人 "好死 "中获得意义感;他们能够通过宣传 VAD 和独特的仪式与亲人保持联系;他们能够通过了解确切的死亡时间来进行有效的计划和准备。家庭成员和照护者还注意到,VAD 给悲伤和丧亲之痛带来了一些重大挑战,特别是 VAD 对家庭关系的影响以及与道德困境相关的负担。尽管如此,家庭成员和照护者普遍对自愿丧亡评估持积极态度,他们对减轻亲人的痛苦表示感谢。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Impact of Voluntary Assisted Dying on Grief and Bereavement for Family Members and Carers in the Australian State of Victoria: A Qualitative Study

Prior to its introduction in Australia, many people opposed euthanasia—or voluntary assisted dying as it is known—because of its potentially detrimental impact on grief and bereavement outcomes for family members and carers. We examine the novel experiences of grief and bereavement of VAD for family members and carers who were going through, had gone through, or were contemplating VAD, juxtaposing the international literature on grief and bereavement. As such, 42 semistructured interviews with family members and carers were undertaken in the state of Victoria, which was the first jurisdiction to legislate in favour of VAD. Interviews explored many themes around end-of-life decision-making in order to ascertain the ways in which VAD helped or hindered grief and bereavement processes. A thematic analysis of the interview data was undertaken using QSR NVivo software. Four key themes were identified: values and meaning-making, expression of a continuing bond, anticipatory grief, and the burden of care associated with supporting loved ones going through VAD. These themes were juxtaposed with the key literature on grief and bereavement to demonstrate how VAD presents novel challenges for carers. We argue that while VAD deaths share similar characteristics to other deaths; in some respects, grief and bereavement outcomes for family members and carers are unique. For family members and carers helping a loved one go through VAD, they were able to derive a sense of meaning from fulfilling their wishes and striving for them to have a “good death”; they were able to maintain a bond with them through advocacy of VAD and unique rituals; and they were able to plan and prepare effectively by knowing the exact time of death. Family members and carers also noted that VAD presents some significant challenges for grief and bereavement, especially in terms of the impact of VAD on familial relationships and burdens associated with moral predicaments. Nonetheless, VAD was generally viewed positively by family members and carers, who expressed gratitude for mitigating their loved one’s suffering.

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来源期刊
CiteScore
4.50
自引率
8.30%
发文量
423
期刊介绍: Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues
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