临终关怀中照顾者的需求是多种多样的,但又看不见:这是一种叙事回顾。

4区 医学 Q2 Nursing
Annals of palliative medicine Pub Date : 2025-03-01 Epub Date: 2025-03-18 DOI:10.21037/apm-24-151
Alice Koo, Michelle Low, Zhi-Zheng Yeo, Jonathan Ee, Poh-Heng Chong
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引用次数: 0

摘要

背景和目的:非正式照护者对居家临终关怀(EOL)至关重要。然而,他们的需求往往没有得到很好的理解和描述,而不是从“以照顾者为中心”的角度来描述。本综述旨在提供EOL照顾者需求的研究概况,讨论需求的类型、影响需求的因素以及支持照顾者的差距。方法:进行非系统的叙述性回顾,以提供看护者需求研究的广泛概述。在PubMed上进行了针对性搜索。搜索词包括“照顾者需求”、“担忧”、“经历”、“姑息治疗”、“临终关怀”和“临终关怀”。定性和定量研究,2019年1月至2024年11月的审查。对选定的论文进行分析,提炼出护理人员需求类型的主题,以及影响他们的背景因素和障碍。评估工具和过程也包括在内。主要内容和发现:共纳入63篇论文。主要研究结果表明,护理人员通常优先考虑“护理支持需求”,如信息获取和后勤支持,而不是个人的“直接支持”需求,其中包括验证需求、对其自主性的认可和关系需求。虽然护理人员的需求越来越受到重视,但在解决这些问题方面仍存在很大差距,其程度也因环境因素而异,如患者的病情、资源的可用性和文化规范。确定的障碍包括持续的患者需求优先于自我,提供者之间的次优文化敏感性,以及普遍缺乏需求评估工具。结论:在EOL护理中,提供者认识到护理人员是患者必不可少的合作伙伴和共同客户是至关重要的。有必要认识到照顾者的直接支持和护理支持需求,以确保照顾者的福祉也得到照顾。可以通过培养对环境因素的敏感性和实施评估过程,更多地关注提高照顾者需求的可见性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Caregiver needs in end-of-life care are diverse, yet invisible: a narrative review.

Background and objective: Informal caregivers are essential to home-based end-of-life (EOL) care. However, their needs are often not well-understood and described in relation to caregiving, rather than with a 'caregiver-centric' perspective. This review aimed to provide an overview of research on EOL caregiver needs, discussing the types of needs, factors that influence them, and gaps in supporting caregivers.

Methods: An unsystematic narrative review was performed to provide a broad overview of caregiver needs research. A targeted search was done on PubMed. Search terms included "caregiver needs", "concerns", "experiences", "palliative", "hospice", and "end-of-life". Qualitative and quantitative studies, reviews between January 2019 and November 2024. Selected papers were analysed to distil themes on the types of caregiver needs, as well as contextual factors and barriers that impact them. Assessment tools and processes were also included.

Key content and findings: A total of 63 papers were included. Major findings showed that caregivers often prioritize 'care-enabling needs'-such as information access and logistic support-over their personal 'direct support' needs-which encompasses the need for validation, recognition of their autonomy, and relational needs. While caregiver needs are increasingly appreciated, there remained substantial gaps in addressing them, the extent of which also varying due to contextual factors, such as patient's condition, availability of resources, and cultural norms. Barriers identified included ongoing prioritization of patient needs above self, suboptimal cultural sensitivity among providers, and general lack of needs assessment tools.

Conclusions: In EOL care, it is critical that providers acknowledge that caregivers are essential partners and a co-client to the patient. There is a need to recognize caregivers' direct support alongside care-enabling needs to ensure caregivers' well-being are also looked after. More attention can be given to increasing the visibility of caregiver needs by developing sensitivity to contextual factors and implementing assessment processes.

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来源期刊
Annals of palliative medicine
Annals of palliative medicine Medicine-Anesthesiology and Pain Medicine
自引率
0.00%
发文量
231
期刊介绍: Annals of Palliative Medicine (Ann Palliat Med; Print ISSN 2224-5820; Online ISSN 2224-5839) is an open access, international, peer-reviewed journal published quarterly with both online and printed copies since 2012. The aim of the journal is to provide up-to-date and cutting-edge information and professional support for health care providers in palliative medicine disciplines to improve the quality of life for patients and their families and caregivers.
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