PDF(Pubmed)
Abstract：
BACKGROUND: Research evidence suggests that a lack of engagement with palliative care and advance care planning could be attributed to a lack of knowledge, presence of misconceptions and stigma within the general public. However, the importance of how death, dying and bereavement are viewed and experienced has been highlighted as an important aspect in enabling public health approaches to palliative care. Therefore, research which explores the public views on strategies to facilitate engagement with palliative care and advance care planning is required.
METHODS: Exploratory, qualitative design, utilising purposive random sampling from a database of participants involved in a larger mixed methods study. Online semi-structured interviews were conducted (n = 28) and analysed using reflexive thematic analysis. Thematic findings were mapped to the social-ecological model framework to provide a holistic understanding of public behaviours in relation to palliative care and advance care planning engagement.
RESULTS: Three themes were generated from the data: \"Visibility and relatability\"; \"Embedding opportunities for engagement into everyday life\"; \"Societal and cultural barriers to open discussion\". Evidence of interaction across all five social ecological model levels was identified across the themes, suggesting a multi-level public health approach incorporating individual, social, structural and cultural aspects is required for effective public engagement.
CONCLUSIONS: Public views around potential strategies for effective engagement in palliative care and advance care planning services were found to be multifaceted. Participants suggested an increase in visibility within the public domain to be a significant area of consideration. Additionally, enhancing opportunities for the public to engage in palliative care and advance care planning within everyday life, such as education within schools, is suggested to improve death literacy and reduce stigma. For effective communication, socio-cultural aspects need to be explored when developing strategies for engagement with all members of society.
METHODS: Exploratory, qualitative design, utilising purposive random sampling from a database of participants involved in a larger mixed methods study. Online semi-structured interviews were conducted (n = 28) and analysed using reflexive thematic analysis. Thematic findings were mapped to the social-ecological model framework to provide a holistic understanding of public behaviours in relation to palliative care and advance care planning engagement.
RESULTS: Three themes were generated from the data: \"Visibility and relatability\"; \"Embedding opportunities for engagement into everyday life\"; \"Societal and cultural barriers to open discussion\". Evidence of interaction across all five social ecological model levels was identified across the themes, suggesting a multi-level public health approach incorporating individual, social, structural and cultural aspects is required for effective public engagement.
CONCLUSIONS: Public views around potential strategies for effective engagement in palliative care and advance care planning services were found to be multifaceted. Participants suggested an increase in visibility within the public domain to be a significant area of consideration. Additionally, enhancing opportunities for the public to engage in palliative care and advance care planning within everyday life, such as education within schools, is suggested to improve death literacy and reduce stigma. For effective communication, socio-cultural aspects need to be explored when developing strategies for engagement with all members of society.
摘要：
背景：研究证据表明，缺乏对姑息治疗和预先护理计划的参与可能归因于缺乏知识，公众中存在误解和污名。然而,死亡的重要性，死亡和丧亲被认为是实现姑息治疗的公共卫生方法的一个重要方面。因此,需要进行研究，以探讨公众对促进姑息治疗和预先护理计划的策略的看法。
方法：探索性，定性设计，利用参与较大混合方法研究的参与者数据库中的有目的随机抽样。进行了在线半结构化访谈（n=28），并使用反身主题分析进行了分析。将主题发现映射到社会生态模型框架中，以全面了解与姑息治疗和提前护理计划参与有关的公共行为。
结果：从数据中产生了三个主题：“可见性和相关性”；“将参与机会嵌入日常生活”；“公开讨论的社会和文化障碍”。跨主题确定了所有五个社会生态模型级别的相互作用的证据，建议采用多层次的公共卫生方法，包括个人，社会,有效的公众参与需要结构和文化方面。
结论：公众对有效参与姑息治疗和预先护理计划服务的潜在策略的看法是多方面的。与会者建议提高公共领域的知名度是一个重要的考虑领域。此外,增加公众在日常生活中参与姑息治疗和预先护理计划的机会，比如学校内的教育，建议提高死亡素养并减少污名。为了有效的沟通，在制定与社会所有成员接触的战略时，需要探索社会文化方面。
方法：探索性，定性设计，利用参与较大混合方法研究的参与者数据库中的有目的随机抽样。进行了在线半结构化访谈（n=28），并使用反身主题分析进行了分析。将主题发现映射到社会生态模型框架中，以全面了解与姑息治疗和提前护理计划参与有关的公共行为。
结果：从数据中产生了三个主题：“可见性和相关性”；“将参与机会嵌入日常生活”；“公开讨论的社会和文化障碍”。跨主题确定了所有五个社会生态模型级别的相互作用的证据，建议采用多层次的公共卫生方法，包括个人，社会,有效的公众参与需要结构和文化方面。
结论：公众对有效参与姑息治疗和预先护理计划服务的潜在策略的看法是多方面的。与会者建议提高公共领域的知名度是一个重要的考虑领域。此外,增加公众在日常生活中参与姑息治疗和预先护理计划的机会，比如学校内的教育，建议提高死亡素养并减少污名。为了有效的沟通，在制定与社会所有成员接触的战略时，需要探索社会文化方面。
