Identifying socio-environmental factors that facilitate resilience among Canadian palliative family caregivers: A qualitative case study
Identifying socio-environmental factors that facilitate resilience among Canadian palliative family caregivers: A qualitative case study
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DOI：
10.1017/s1478951513001028
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发表时间：
2015-06-01
影响因子：
2.2
通讯作者：
Stajduhar, Kelli
中科院分区：
文献类型：
--
作者：
Giesbrecht, Melissa;Wolse, Faye;Stajduhar, Kelli
目标：在加拿大，朋友和家人越来越有责任在家中提供姑息治疗。这导致一些护理人员承受很高的压力和负担，最终可能超出他们的应对能力。最近的姑息治疗研究表明，在这种情况下，护理人员具有恢复能力的潜力。然而，这项研究主要侧重于探索有助于恢复力的个人层面因素，最大限度地减少这一概念固有的复杂性，以及它如何同时受到一个人的社会背景的影响。因此，我们的研究旨在确定在加拿大家庭护理背景下有助于姑息性家庭护理人员复原力的社会环境因素。方法：利用民族志实地记录和对家庭护理人员、护理接受者和家庭护理护士的半结构化访谈，这项二次分析采用交叉视角和定性案例研究方法来确定促进家庭护理的社会环境因素 照顾者的复原能力。采用案例研究方法，特意选择了两个案例进行分析。结果：研究结果表明，家庭照顾者的复原力不仅受到个人因素的影响，还受到社会环境的影响，社会环境设定了照顾者角色体验的生活背景。这两个案例研究的主题结果揭示了在塑造复原力方面发挥作用的六个社会环境因素：社交网络的获取、教育/知识/意识、就业状况、住房状况、地理位置和生命历程阶段。结果的意义：通过实证证明社会环境因素在护理体验中的作用，研究结果为现有的护理人员复原力研究做出了贡献。此外，利用交叉方法，这些发现建立在现有概念的基础上，即复原力是一个多维且复杂的过程，受到众多相关变量的影响，这些变量交叉产生积极或消极的体验。讨论了结果对优化最佳家庭护理实践的影响。
Objective: In Canada, friends and family members are becoming increasingly responsible for providing palliative care in the home. This is resulting in some caregivers experiencing high levels of stress and burden that may ultimately surpass their ability to cope. Recent palliative care research has demonstrated the potential for caregiver resilience within such contexts. This research, however, is primarily focused on exploring individual-level factors that contribute to resilience, minimizing the inherent complexity of this concept, and how it is simultaneously influenced by one's social context. Therefore, our study aims to identify socio-environmental factors that contribute to palliative family caregiver resilience in the Canadian homecare context.Methods: Drawing on ethnographic fieldnotes and semistructured interviews with family caregivers, care recipients, and homecare nurses, this secondary analysis employs an intersectionality lens and qualitative case study approach to identify socio-environmental factors that facilitate family caregivers' capacity for resilience. Following a case study methodology, two cases are purposely selected for analysis.Results: Findings demonstrate that family caregiver resilience is influenced not only by individual-level factors but also by the social environment, which sets the lived context from which caregiving roles are experienced. Thematic findings of the two case studies revealed six socio-environmental factors that play a role in shaping resilience: access to social networks, education/knowledge/awareness, employment status, housing status, geographic location, and life-course stage.Significance of Results: Findings contribute to existing research on caregiver resilience by empirically demonstrating the role of socio-environmental factors in caregiving experiences. Furthermore, utilizing an intersectional approach, these findings build on existing notions that resilience is a multidimensional and complex process influenced by numerous related variables that intersect to create either positive or negative experiences. The implications of the results for optimizing best homecare nursing practice are discussed.