Dignity in the terminally ill: a developing empirical model
Dignity in the terminally ill: a developing empirical model
复制标题
DOI：
10.1016/s0277-9536(01)00084-3
复制
发表时间：
2002-02-01
影响因子：
5.4
通讯作者：
Harlos, M
中科院分区：
文献类型：
--
作者：
Chochinov, HM;Hack, T;Harlos, M
尽管在支持和反对病人在与死亡有关的事务上自我管理的论点中使用了尊严一词，但关于濒临死亡的病人如何使用这一术语的实证研究很少。这项研究的目的是确定临终病人如何理解和定义尊严一词，以便在临终病人中建立尊严的模式。一项半结构化的访谈旨在探索患者如何应对晚期癌症，并详细说明他们对尊严的看法。采访被录音并逐字转录。在15个月的时间里，从一家拥有姑息治疗专科单元的城市延伸护理医院招募了50名同意接受晚期癌症治疗的患者作为连续样本。该股既提供住院服务，又协调以临终关怀社区为基础的规划。使用潜伏期分析和恒定比较技术对数据进行分析。研究团队的四名成员独立地对转录的数据进行了编码，以开发出概念上有意义的反应类别。编写了主要类别、主题和分主题的业务定义。定性分析得出了三个主要类别，包括与疾病有关的关切、维护尊严的剧目和社会尊严清单。这些广泛的类别及其精心定义的主题和副主题构成了死亡中尊严的新兴模式的基础。尊严的概念和尊严模型提供了一种理解患者如何面对晚期疾病的方法。这将有助于提高临终病人的尊严和生活质量。(C)2002爱思唯尔科学有限公司。保留所有权利。
Despite use of the term dignity in arguments for and against a patient's self-governance in matters pertaining to death, there is little empirical research on how this term has been used by patients who are nearing death. The objective of this study was to determine how dying patients understand and define the term dignity in order to develop a model of dignity in the terminally ill. A semi-structured interview was designed to explore how patients cope with their advanced cancer and to detail their perceptions of dignity. Interviews were audiotaped and transcribed verbatim. A consecutive sample of 50 consenting patients with advanced terminal cancer were recruited over a 15-month period of time from an urban extended care hospital housing a specialized unit for palliative care. This unit provides both inpatient services, and coordinates end-of-life care community based programming. Data were analysed using latent content analysis and constant comparison techniques. Four members of the research team independently coded the transcribed data, to develop conceptually meaningful categories of responses. Operational definitions were written for major categories, themes and sub-themes. Three major categories emerged from the qualitative analysis, including illness-related concerns; dignity conserving repertoire, and social dignity inventory. These broad categories and their carefully defined themes and sub-themes form the foundation for an emerging model of dignity amongst the dying. The concept of dignity and the dignity model offer a way of understanding how patients face advancing terminal illness. This will serve to promote dignity and the quality of life of patients nearing death. (C) 2002 Elsevier Science Ltd. All rights reserved.