中华传统文化视角下疾病终末期患者尊严模型解析

Explanation of the Dignity Model for end-stage patients on the perspective of Chinese culture

目的:解析加拿大Chochinov疾病终末期患者尊严模型在中华文化情境下的适用性,并基于此对模型进行调适。方法:采用内容分析法,按照选定分析范围、抽取样本、确定分析单位和分析框架、资料分析四步完成。首先检索中、英文数据库中以中华文化背景下临终尊严为主题的文献,然后以尊严模型为框架对文献内容进行编码、归纳和分析。结果:尊严模型包含的多数主题符合我国临终患者的认知,如身体功能、医疗不确定性、死亡焦虑、隐私界限、照护要旨、他人负担、后事担忧等。但也出现了矛盾的主题,如忍受痛苦、自主性等,以及新的主题,包括家庭支持、病耻感和财务担忧。结论:加拿大版疾病终末期患者尊严模型并不完全符合中国文化,调适后的尊严模型更具我国文化特色,但仍需实证研究对模型进行验证。

Objective: To analyze the applicability of the Dignity Model for terminally ill patients on the perspective of Chinese culture, and to adapt the Dignity Model from the perspective of Chinese culture. Methods: Content analysis method was used in the study. Chinese and English databases were searched with the theme of dignity of terminally ill patients under the background of Chinese culture, and the literature were coded, summarized and analyzed within the framework of Dignity Model. Results: Most themes included in the Dignity Model fitted the perception of terminally ill patients in China, such as functional capacity, medical uncertainty, death anxiety, privacy boundaries, care tenor, burden to others, aftermath concerns, and so on;but there were several subthemes contradicted the Chinese perspective, such as endurance of suffering, autonomy, and so on. Meanwhile, three new subthemes emerged, including family supports, stigma, and financial concerns. Conclusion: The Canadian Dignity Model for terminally ill patients is not entirely consistent with Chinese culture, and the adapted dignity model is more culturally sensitive but needs to be further verified by empirical research.