| Summary: | 碩士 === 高雄醫學大學 === 護理學系碩士班 === 104 === Thanks to the promotion of hospice and palliative care in recent years, the concept of hospice shared-care has begun to become a reality among medical teams. The so-called hospice care does not mean giving up on life and its implementation is not restricted to hospice units, but can be anywhere anytime to ensure that patients leave the world with dignity and without regrets at the end of their lives. Home-based hospice care shifts the responsibility of taking care of terminally ill patients from hospital units to their family members, but this process puts main caregivers under tremendous physiological and psychological stress. Based on clinically observed and perceived stress experienced by main caregivers for terminally ill patients and inadequate experience among nursing staff in giving support for dealing with grief, the author intended to investigate the experience in helping main caregivers in home-based hospice care to deal with anticipatory grief through this study.
This study was an exploratory qualitative research on 16 participants sampled from the main caregivers providing home-based hospice care for patients from a medical center in Tainan City, Taiwan. Data was collected using open-ended in-depth interviews that guided the main caregivers for terminally ill patients to voice their experiences and feelings while providing home care in their natural home environments. The interviewer conducted the interviews based on a semi-structured interview outline in the data collection process and added field-based participant observation to obtain field notes for further data collection.
The paper-based content in interview recordings was translated into a transcript that was subject to the thematic form of qualitative data analysis for further exploration into the anticipatory grief experienced by the main caregivers and how their states of mind changed through sequential coding of the transcript content, development of conceptual categories and theme induction. Out of the 102 codes obtained from the initial findings, 61 codes were finalized through refined filtering of similar concepts and were divided based on their content into 14 subthemes under 4 themes, which included ‘revelation and implications of the nature of life’, ‘the art of coping with one’s own impending death’, ‘self-realization and gifts before passing’ and ‘adjustment for controlled coping and loss of control’, all of which interacted and constituted an ongoing and dynamic process.
The results of this study can provide guidance for hospice professionals on helping main caregivers in home-based hospice care to cope with anticipatory grief when their terminally ill family members are near their end. They can also serve as the basis for guiding the process of grief counseling for caregivers in home-based hospice care, expanding localized grief counseling measures, and providing comprehensive materials for life and death education in nursing that help positive nursing attitudes to take root, thereby providing more appropriate nursing services for terminally ill patients and their families.
|
|---|
