Constructing Understandings of End- of- Life Care in Europe: A Qualitative Study Involving Cognitive Interviewing with Implications for Cross- National Surveys
Constructing Understandings of End- of- Life Care in Europe: A Qualitative Study Involving Cognitive Interviewing with Implications for Cross- National Surveys
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DOI：
10.1089/jpm.2010.0348
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发表时间：
2011-03-01
影响因子：
2.8
通讯作者：
Gomes, Barbara
中科院分区：
文献类型：
--
作者：
Daveson, Barbara A.;Bechinger-English, Dorothee;Gomes, Barbara
背景：尽管在欧洲有关于人们临终关怀（EoLC）偏好和优先事项的国家调查结果，但国家之间缺乏研究协调意味着对EoLC的跨国理解仍然未知。目的：(1)在EoLC调查的背景下确定英语和德语对EoLC的理解，(2)综合这些理解，以帮助解释跨国调查的结果。方法：采用归纳和解释两阶段顺序设计，包括：(1)定性分析来自15名英国和15名德国受访者的认知访谈数据，以制定与国家相关的类别；(2)定性综合，以确定对EoLC的概念连贯理解。结果：开放和轴向编码产生6个英语和6个德语分类。共性包括(a)社会和关系维度的重要性，(b)包含不确定性的动态决策，(c)对生命质量和数量的重视，以及(d)对整体护理的期望，包括自主、选择和来自可信赖专业人员的及时信息。差异包括对实际问题的关注，对延长生命的思考，首选的死亡地点，以及媒体和环境的作用。综合产生了四个具有潜在一致性的概念：对涉及自主性、选择和背景的高标准EoLC的期望；在预期变化中不断变化的决策；对生活和存在的思考；以及在真实和假设场景中塑造EoLC偏好的世界观。结论：在量化EoLC理解时，必须记住个体和国家相关的多样性。对认知访谈数据的归纳-解释分析有助于对调查结果的解释。跨国研究协调和定性综合协助欧洲的EoLC。
Background: Although national findings regarding people's end-of-life care (EoLC) preferences and priorities are available within Europe, a lack of research coordination between countries has meant that cross-national understandings of EoLC remain unknown.Purpose: To (1) identify English and German understandings of EoLC within the context of an EoLC survey, and (2) to synthesise these understandings to aid interpretation of results from a cross-national survey.Methods: An inductive and interpretive two-phased sequential design involving (1) qualitative analysis of cognitive interview data from 15 English and 15 German respondents to develop country-related categories, and (2) qualitative synthesis to identify a conceptually coherent understanding of EoLC.Results: Open and axial coding resulted in six English and six German categories. Commonalities included (a) the importance of social and relational dimensions, (b) dynamic decision making comprising uncertainty, (c) a valuing of life's quality and quantity, and (d) expectations for holistic care involving autonomy, choice, and timely information from trusted professionals. Differences involved attention to practical matters, and thoughts about prolongation of life, preferred place of death, and the role of media and context. Synthesis resulted in four concepts with underlying coherence: expectations of a high standard of EoLC involving autonomy, choice, and context; evolving decision making amid anticipated change; thoughts about living and existing; and worldviews shaping EoLC preferences in real and hypothetical scenarios.Conclusion: Individual and country-related diversity must be remembered when quantifying EoLC understandings. Inductive-interpretive analysis of cognitive interview data aids interpretation of survey findings. Cross-national research coordination and qualitative synthesis assists EoLC in Europe.