Honoring the voices of bereaved caregivers: a Metasummary of qualitative research
Honoring the voices of bereaved caregivers: a Metasummary of qualitative research
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DOI：
10.1186/s12904-017-0231-y
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发表时间：
2017-09-06
影响因子：
3.1
通讯作者：
Peacock, Shelley
中科院分区：
文献类型：
--
作者：
Holtslander, Lorraine;Baxter, Sharon;Peacock, Shelley
背景：特别是在疾病晚期的情况下，家庭护理可能是身体和情感上的负担。照顾者随后可能面临丧亲之痛，因为支持很少，资源有限，而且很大一部分人会产生负面的心理和社会后果。虽然一些研究关注了家庭照顾者的丧亲经历，这些家庭照顾者曾照顾过需要姑息治疗的人，但对护理对丧亲影响的全面定性理解尚未得到阐明。本研究的目的是进行定性元总结，以探讨接受姑息治疗服务的人的丧失亲人的家庭照顾者的经验，无论他们的潜在疾病。方法：采用Sandelowski和Barroso的定性元总结方法：通过广泛的数据库检索（即MEDLINE， PsychINFO和CINAHL）确定1287篇文章，并对其进行审查，以确定它们是否符合标准。对纳入综述的研究进行了研究质量评估。然后对每项研究的结果进行主题编码，并计算主题的频率。结果：样本包括47项定性研究。总共出现了15个主题。按频率降序排列，这15个主题是：平静、悲伤、内疚、不确定、创伤、逃避和愤怒的个人情绪；在丧亲之痛中帮助照顾者的丧后经历；失去亲人后的经历阻碍；实际生活变化；照顾者角色认同；亏损前的经历有所帮助；损失前的经历阻碍了；照顾者上下文;并且需要不同种类的支持。从这些主题中得出了三个主要发现：(1)照顾经历的许多不同方面影响丧亲体验；(2)每次丧亲体验都是独特的；(3)必须开发各种支持，并为照顾者提供支持，以满足这些独特的需求。结论：根据元总结的研究结果，需要改变实践和政策，以确保在照顾和丧亲期间提供支持，以维持家庭照顾者的健康和福祉。
Background: Family caregiving in the context of advanced disease in particular, can be physically and emotionally taxing. Caregivers can subsequently face bereavement exhausted with few supports, limited resources and a significant proportion will develop negative psychological and social outcomes. Although some research has attended to the bereavement experiences of family caregivers who had cared for a person requiring palliative care, a comprehensive qualitative understanding of the impact of caregiving on bereavement has not been articulated. The purpose of this study was to conduct a qualitative metasummary to explore the experiences of bereaved family caregivers of people who received palliative care services, regardless of their underlying disease.Methods: Sandelowski and Barroso's qualitative metasummary method was utilized: 1287 articles were identified through extensive database searches (i.e. - MEDLINE, PsychINFO, and CINAHL) and reviewed to determine if they fit the criteria. Those included in the review were assessed for study quality. Findings from each study were then thematically coded and a frequency of themes was calculated.Results: The sample consisted of 47 qualitative studies. A total of 15 themes emerged. In descending order of frequency, the 15 themes were: the individual emotions of serenity, sadness, guilt, uncertainty, trauma, escape, and anger; post-loss experiences that helped the caregiver in bereavement; post-loss experiences that hindered; practical life changes; caregiver role identity; pre-loss experiences that helped; pre-loss experiences that hindered; caregiver context; and a need for different kinds of supports. Three key findings emerged from the themes: (1) many different aspects of the caregiving experience impact the bereavement experience, (2) every bereavement experience is unique, and (3) a variety of supports must be developed and made available to caregivers to meet these unique needs.Conclusions: Based on the metasummary findings, changes are needed in practice and policy to ensure the health and well-being of the family caregiver is maintained by offering support both during caregiving and bereavement.