What is a 'secure base' when death is approaching? A study applying attachment theory to adult patients' and family members' experiences of palliative home care
What is a 'secure base' when death is approaching? A study applying attachment theory to adult patients' and family members' experiences of palliative home care
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DOI：
10.1002/pon.1982
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发表时间：
2012-08-01
期刊：
影响因子：
3.6
通讯作者：
Friedrichsen, M.
中科院分区：
文献类型：
--
作者：
Milberg, A.;Wahlberg, R.;Friedrichsen, M.
目的依恋理论近来在成人如何应对压力和严重疾病方面受到了极大的关注。这项研究的目的是利用患者和家庭成员的经历来探索姑息家庭护理作为安全基础的问题(这是该理论中的一个中心概念)。方法对12名患者和14名家庭成员在姑息治疗期间进行访谈。访谈采用演绎的定性内容分析方法。结果被调查者表达了在姑息家庭护理中感受到安全感的相关性，因为死亡和垂死是导致脆弱性的威胁。姑息家庭护理可以培养一种安全感，并提供一个安全的基础。当举报人信任工作人员(例如，由于提供症状缓解方面的可用性和能力)、认为自己是个人并欢迎在需要时与小组联系时，这一点就得到了促进。舒适、见多识广和拥有日常生活也有助于人们认为姑息家庭护理是安全的基础。家庭成员强调从过重的责任中解脱出来的重要性。体验作为安全基础的姑息家庭护理的潜在意义包括获得一种控制感和内心的平和，意识到尽管生活状况要求很高和发生了变化，一个人仍然可以部分地做自己，有希望的东西，即使这不再涉及对病人的治疗。结论：姑息家庭护理的重要方面被确定为提供安全的基础，这些方面对临床实践有意义。版权所有(C)2011 John Wiley&Sons，Ltd.
Objective Attachment theory has received much interest lately in relation to how adults cope with stress and severe illness. The aim of this study was using the experiences of patients and family members to explore palliative home care as a secure base (a central concept within the theory). Methods Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed with deductive qualitative content analysis. Results Informants expressed the relevance of sensing security during palliative home care because death and dying were threats that contributed to vulnerability. Palliative home care could foster a feeling of security and provide a secure base. This was facilitated when informants had trust in staff (e.g. due to availability and competence in providing symptom relief), felt recognised as individuals and welcomed to contact the team in times of needs. Being comfortable, informed and having an everyday life also contributed to a perception of palliative home care as a secure base. Family members stressed the importance of being relieved from responsibilities that were too heavy. The underlying meanings of experiencing palliative home care as a secure base involved gaining a sense of control and of inner peace, perceiving that despite a demanding and changed life situation, one could continue partially being oneself and having something to hope for, even if this no longer concerned cure for the ill person. Conclusions Important aspects of palliative home care as providing a secure base were identified and these have implications for clinical practice. Copyright (c) 2011 John Wiley & Sons, Ltd.