RESUMO
Background: Medical Assistance in Dying (MAiD) was legalized in Canada in June 2016. MAiD is available to those who are at least 18 years of age with an irremediable medical condition and an irreversible state of decline causing unbearable suffering. Between June 2016 and December 2019, 13,946 MAiD cases were reported in Canada.3 Although 35.2% have taken place in the home, very little is known about the experience of caregivers in this setting. Objectives: This study explored caregivers' experience with MAiD in the home-setting and their bereavement process. Setting/Subjects: Caregivers of patients of the Temmy Latner Centre for Palliative Care in Toronto, Canada, who underwent MAiD by a physician at home. This study was approved by the Sinai Health Research Ethics Board. Design: This study used a semistructured interview guide and standardized questionnaires. Thirteen caregivers were contacted at least six months post-MAiD to participate in a one-on-one interview. The interviews were transcribed, coded, and evaluated using a thematic analysis approach. Results: The main themes that emerged from the interviews were the caregivers' experience with MAiD, their interaction with the MAiD team, disclosure about MAiD, their bereavement experience, and comparison of experiencing a MAiD death to a natural death. Conclusion: We hypothesize that caregivers in our study were better prepared for the upcoming death due to more certainty as to how and when their loved one would die. Having closure and being able to say goodbye may also have positively influenced the bereavement experience. Finally, MAiD may have spared the caregivers the trauma of witnessing their loved one deteriorate in their final days of life.
Assuntos
Luto , Suicídio Assistido , Canadá , Cuidadores , Humanos , Assistência Médica , Pesquisa QualitativaRESUMO
BACKGROUND: Home-based palliative care is care of the patient in their home, while doctors and other healthcare providers (HCPs) make visits as required. Family involvement naturally cultivates a relationship between HCPs and the family. Once the patient dies and home-based palliative care ends, this relationship is abruptly terminated, which may be challenging to both the family and the HCPs. The objective of this study was to understand the thoughts and opinions of HCPs and families on their encountered loss of relationship at the end of home-based palliative care. METHODS: Perceptions of 63 participants (32 HCPs and 31 family members) were explored using semi-structured interviews and the qualitative research methodologies of grounded theory. HCPs were interviewed at the Temmy Latner Centre for Palliative Care (TLCPC), a home-based palliative care group of physicians, and 2 hospitals in Toronto, while family members were recruited from TLCPC's records of deceased patients. RESULTS: Six overarching themes, relating to HCP-family relationship dynamics, the experience of loss of relationship, and potential solutions, were derived from the data: (I) home palliative care is intimate; (II) dissatisfaction is experienced with abrupt relationship ending; (III) families benefit from open communication, especially after patient death; (IV) HCPs recognize the insufficiency in bereavement resources; (V) benefits are recognized for a system to ease loss of relationship, and lastly; (VI) challenges with introducing such a system concern HCP. CONCLUSIONS: Overall, families and HCPs do not like the loss of relationship post-patient death, and recognize the potential benefits of an approach that would allow for communication going forward.
Assuntos
Luto , Morte , Família , Pessoal de Saúde , Adulto , Idoso , Feminino , Serviços de Assistência Domiciliar , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Cuidados PaliativosRESUMO
Researchers have examined the fit or match between a person and an organization extensively in the empirical literature. Overall findings have supported the existence of a positive relation between the congruence of employee and organizational values with employee attitudes toward the organization. However, this relation is not fully understood, and more research is needed to understand the relation between the congruence of different value dimensions and multiple employee attitudes. Therefore, the authors aimed to analyze value congruence across 7 dimensions and its relation to (a) job satisfaction, (b) organizational commitment, (c) satisfaction with the organization as a whole, and (d) turnover intentions. The results suggest that the perceived congruence of employee-organizational values by employees is positively associated with satisfaction with the job and organization as a whole and employee commitment to the organization. The results also support a negative relation between value congruence and employee turnover intentions.
Assuntos
Satisfação no Emprego , Cultura Organizacional , Lealdade ao Trabalho , Reorganização de Recursos Humanos , Adolescente , Adulto , Cultura , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio Social , Estudantes/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
This pilot study tested the effects of an interactive nutrition education Web site on fruit, vegetable, and fat consumption in minority adolescents genetically at risk for Type 2 diabetes. A one-group nonexperimental pretest, posttest focus group design was used. Twenty-one sixth-grade to eighth-grade junior high adolescents who were minorities volunteered to participate. Participants received 5 hours of Web-based nutrition education over 3 weeks. A significant difference in fat consumption was supported from the computerized dietary assessment. No difference was found in fruit or vegetable consumption. Comparative data indicated a rise in body mass index (BMI) percentile from 88.03 (1999) to 88.40 (2002; boys) and 88.25 (1999) to 91.2 (2002; girls). Focus group responses supported the satisfaction of adolescents in the study with the use of the Web-based intervention for nutrition education. Healthy eating interventions using Web-based nutrition education should be further investigated with adolescents.