"Just Let Me Go": End-of-Life Planning Among Ojibwe Elders.
"Just Let Me Go": End-of-Life Planning Among Ojibwe Elders.
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“放我走吧”：奥及布威长者的临终规划。
DOI：
10.1093/geront/gnw151
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Washington,KarlaT
中科院分区：
文献类型：
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作者：
Dennis,MaryKate;Washington,KarlaT
研究的目的虽然提前护理计划（ACP）的目的是促进以人为本的临终关怀，其基础的原则与许多美国印第安人/阿拉斯加原住民（AI/AN）社区的价值观和规范不一致，导致AI/AN老年人的ACP率较低。本研究的目的是探讨西方的方法之间的明显的紧张关系，以结束生命的护理，包括它的重点ACP，和期望和愿望的一个社区的AI老年人，在希望通知更多的文化上适当的方法来规划结束生命的护理。设计和MethodsAbout 20部落长老生活在一个五大湖保留参加了半结构化，面对面的采访。参与者是通过方便和雪球抽样技术招募的。访谈进行了分析，使用归纳专题分析approach.ResultsDespite看到ACP的需要很少，老年人普遍开放讨论的照顾，他们希望在生命的尽头。许多人能够很容易地描述他们希望和平死亡的愿望，并已经制定了葬礼和埋葬或火葬计划。虽然建立一个人的个人遗产是不是一个显着的生命结束的关注的长者，几个发现的意义，在描述他们的贡献，以保护他们的家庭，社区，和他们的文化lifeways.ImplicationsA缺乏正式的ACP内AI/AN社区并不一定反映了文化厌恶讨论的偏好结束生命。承认死亡和死亡对许多AI/AN个人的精神和文化意义，可能会加强在部落社区增加ACP的努力。
Purpose of the StudyAlthough advance care planning (ACP) is designed to promote person-centered end-of-life care, the principles underpinning it are at odds with the values and norms of many American Indian/Alaska Native (AI/AN) communities, contributing to low rates of ACP among AI/AN elders. The purpose of this study was to explore the apparent tension between Western approaches to end-of-life care, including its emphasis on ACP, and the expectations and wishes of one community of AI elders, in hopes of informing more culturally appropriate approaches to planning for end-of-life care.Design and MethodsAbout 20 tribal elders living on a Great Lakes reservation participated in semistructured, face-to-face interviews. Participants were recruited through convenience and snowball sampling techniques. The interviews were analyzed using an inductive thematic analysis approach.ResultsDespite seeing little need for ACP, the elders were generally open to discussing the care they would want at end of life. Many were readily able to describe their wishes for a peaceful death and had already developed funeral and burial or cremation plans. Although establishing one’s individual legacy was not a salient end-of-life concern for the elders, several found meaning in describing their contributions to preserving their families, the community, and their cultural lifeways.ImplicationsA lack of formal ACP within AI/AN communities does not necessarily reflect a cultural aversion to discussing preferences for end of life. Efforts to increase ACP in tribal communities would likely be enhanced by acknowledgment of the spiritual and cultural significance of death and dying for many AI/AN individuals.