| Summary: | 碩士 === 長榮大學 === 護理學研究所 === 97 === The purpose of this study was to explore the experience of decision-making for hospice admission among end stage cancer patients’ families. A grounded theory design using in-depth interviews was applied in the study. Using purposed smpling processure, a total of 6 participants were recruited from a hospice ward in a medical center in south Taiwan. The recruit criteria were that the patient had admitted the hospice ward over 72 hours, and the participant should be the primary decision maker. Three categories, seven themes, and twelve sub-themes were found from data analysis. The first category is the pre-decision-making stage which includes three themes: “aware it is time to go”, “exhausted”, and “social network”, and eight sub-themes: “the life died away”, “suffer being”, “fatigue”, “helplessness”, “reluctant to let go ”, “economic resources”, “responsibility of care”, and “the interaction between healthcare team and patient”. Families at this stage experienced conflicts between the end stage care stresses and their hopes in keeping patients’ lives. It is the initial motivation to think about palliative care. The second category is the middle stage of decision-making. There are two themes included in this category: “reflection”, and “the resistance of decision- making”. Under these two themes, four subthemes were presented, namely, “explore patient’s preference”, “decide to let go”, “waited for died”, “administrative restriction”. Finally, post stage of decision- making, is a evaluate process for the decision-making. Two major themes are “settle down” and “time to say goodbye”.
From the result of the study, nurses will have a better understanding of the experience of decision-making for hospice admission among end stage cancer patients’ families. Further suggestion for clinical practice is to enhance nurses’ education about hospice care in order to aware patients and families’ needs in advance and offer help as necessary. For administrative pratice, control the LOS in hospice ward makes the family suffer afer all settle down. Healthcare system need to find a more humanistic care model in considering the holistic care.
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