生命末期家庭照顾体验理论模型的拓展研究  

Expanding the theoretical model of family caregivers′experience of caring for patients at the end-of-life stage

作　　者：来小彬 付芳 Lai Xiaobin;Fu Fang(School of Nursing,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学护理学院基础护理教研室,上海200032 [2]复旦大学社会发展与公共政策学院,上海200032

出　　处：《护理学杂志》2024年第14期110-116,121,共8页Journal of Nursing Science

基　　金：上海市哲学社会科学规划课题(2022BSH004)。

摘　　要：目的进一步完善前期研究初步形成的生命末期家庭照顾体验的理论模型。方法系统检索6个英文数据库和5个中文数据库中发表在2023年3月之前的描述家庭成员在患者生命末期的照顾体验的扎根理论研究。采用主题扩展法和理论生成Meta整合法对纳入的14篇文献进行整合。结果对前期研究形成的生命末期家庭照顾体验的理论模型雏形中的8个核心元素进行了调整,对核心元素内涵进行了扩展。最终形成了包括动机与动力、临终意识、伴行、情绪体验、生活改变、需求、结局和目标7个核心元素的生命末期家庭照顾体验理论模型。理论模型中的多个核心元素受到照顾者自身、患者、家庭、医疗体系以及其他社会层面因素的影响。结论护理人员可根据构建的生命末期家庭照顾体验理论模型给予患者家属个性化的支持和指导,协助家庭照顾者从认知、精神、行为等多个层面应对临终照顾任务。Objective To enrich a preliminary theoretical model of family caregivers′experience of caring for patients at the end-of-life stage.Methods Six English databases and five Chinese databases were systematically searched for the studies of grounded theory interpreting the family members′experience of caring for patients at the end-of-life stage published before March 2023.The 14 included studies were synthesized by using the methods of Thematic Expansion and Theory-generating Meta-synthesis.Results Eight core components of the theoretical model developed in the previous studies have been adjusted and extended.The theoretical model consisted of seven core components:motivation,the awareness of dying,companionship,emotional experience,life changes,needs,consequences and goals.Several core components are influenced by the caregivers,patients,families,the healthcare system,and societal factors.Conclusion Nurses could provide tailored-support based on the theoretical model of family caregivers′experience of caring for patients at the end-of-life stage,and help family caregivers to cope with end-of-life caregiving tasks at multiple levels of cognition,spirit and behavior.

关 键 词：家庭照顾者 临终患者 生命末期 临终照护 照顾体验 家庭支持 优逝 

分 类 号：R47[医药卫生—护理学] R48[医药卫生—临床医学]