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Nursing Science 2024
肿瘤科护士对晚期恶性肿瘤病人安宁疗护感受和经验的质性研究
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Abstract:
目的:为了解贵阳市某三甲医院肿瘤科护理人员对晚期恶性肿瘤病人安宁疗护的真实体验,以更好地为患者提供能满足个体需求的、有针对性的安宁疗护方案,为提高生命质量提供参考。方法:于2024年1月~2024年2月对贵阳市某三甲医院肿瘤科护士进行半结构式访谈,运用Colaizzi资料分析法对资料进行整理、分析并提炼主题。结果:提炼出4个主题,晚期恶性肿瘤病人的需求、医患沟通困难、安宁疗护的介入时机、安宁疗护的提升及培养。结论:肿瘤科护士对于安宁疗护认知和处理能力方面尚存在不足。应尽快规范完善安宁疗护多学科队伍,建立专业系统培训,针对护士对于患者心理支持、沟通能力以及安宁疗护介入时机等方面的不足解决实际问题,从而提升安宁疗护的实践效果,使患者和家属获益。
Objective: To understand the real experience of nursing staff in oncology department of a 3A hospital in Guiyang on hospice care for patients with advanced malignant tumor, and to provide a reference for patients to better meet individual needs and provide targeted hospice care programs to improve their lives. Methods: From January 2024 to February 2024, a semi-structured interview was conducted with nurses in the oncology department of a Grade A hospital in Guiyang. Colaizzi data method was used to sort out and analyze the data and refine the theme. Results: Four themes were extracted: the needs of patients with advanced malignant tumor, the difficulty of communication between doctors and patients, the intervention opportunity of hospice care, and the promotion and cultivation of hospice care. Conclusion: Nurses in oncology department still have some deficiencies in their cognition and management ability of hospice care. It is necessary to standardize and improve the multidisciplinary team of hospice care as soon as possible, establish professional systematic training, and solve practical problems according to the deficiencies of nurses in psychological support, communication ability and intervention time of hospice care, so as to improve the practical effect of hospice care and benefit patients and their families.
[1] | 国家卫生计生委办公厅. 国家卫生计生委办公厅关于印发安宁疗护实践指南(试行)的通知[EB/OL]. http://www.nhc.gov.cn/yzygj/s3593/201702/83797c0261a94781b158dbd76666b717.shtml, 2017-01-25. |
[2] | 杨蓉, 肖军, 樊启娥, 等. 疼痛管理在晚期肿瘤患者安宁疗护中的效果观察探讨[J]. 中外医学研究, 2019, 17(14): 92-93. |
[3] | 张旭政. 安宁疗护对恶性肿瘤晚期患者主要照顾者负性情绪及心理应激的影响分析[J]. 实用中西医结合临床, 2020, 20(1): 175-176. https://doi.org/10.13638/j.issn.1671-4040.2020.01.089 |
[4] | 崔菲, 杨艳平, 赵锐瑾. 安宁疗护联合五行音乐对改善晚期肺癌患者负性情绪及疼痛程度的影响[J]. 齐鲁护理杂志, 2022, 28(17): 131-133. https://doi.org/10.3969/j.issn.1006-7256.2022.17.042 |
[5] | 陈丽君, 陈园园, 刘鹤阳. 安宁疗护在晚期肺癌患者中的应用效果探讨[J]. 临床医学工程, 2023, 30(2): 265-266. https://doi.org/10.3969/j.issn.1674-4659.2023.02.0265 |
[6] | 郭奕嫱, 徐萌泽, 张荣, 等. 护理本科生安宁疗护态度及影响因素调查分析[J]. 护理学杂志, 2020, 35(13): 62-64. |
[7] | 谌永毅, 成琴琴, 刘翔宇, 等. 护士在安宁疗护中的角色和地位[J]. 中国护理管理, 2018, 18(3): 311-315. |
[8] | Colaizzi, P. (1978) Psychological Research as a Phenomenologist Views It. In: Valle, R. and King, M., Eds., Existential Phenomenological Alternatives for Psychology, Oxford University Press, Oxford, 5-7. |
[9] | 张锦欣, 靳英辉, 曹英娟, 等. 慢性病终末期患者优逝期望与需求质性研究的系统评价[J]. 中华护理杂志, 2019, 54(12): 1788-1794. |
[10] | 华红霞, 胡月, 徐研文, 等. 基于三级体系及多学科模式的医护社康体系下安宁疗护应用于临终癌症病人的影响[J]. 全科护理, 2019, 17(31): 3964-3967. |
[11] | 李青, 周燕, 陈婧, 等. 在康复护理临床教学中进行多元化教学模式的初步探索[J]. 中国继续医学教育, 2017, 9(5): 29-31. |
[12] | 潘路晨, 颜巧元, 琚满娣. 癌症患者死亡教育研究进展[J]. 护理学杂志, 2022, 37(1): 103-105. |
[13] | 胡明丽, 贺恋秋, 汪进. 安宁疗护对肿瘤晚期患者死亡认知态度及生活质量的影响[J]. 齐鲁护理杂志, 2020, 26(9): 13-15. |
[14] | 刘宗劲. 医患沟通的检视与突围: 五个基本维度[J]. 自然辩证法通讯, 2020, 42(11): 111-116. https://doi.org/10.15994/j.1000-0763.2020.11.014 |
[15] | 薛小霞, 李淑宇, 陈贞, 等. 阅读疗法对脑卒中偏瘫患者病耻感及主观幸福感的影响[J]. 中国健康心理学杂志, 2020, 28(6): 865-867. |
[16] | 何璀, 余利平, 徐汉明. 阅读式疗法在创伤后应激障碍患者心理治疗中的应用[J]. 神经损伤与功能重建, 2020, 15(4): 235-237, 239. |
[17] | 张茜雯, 梅永霞, 张振香, 等. 阅读疗法对晚期肺癌患者照顾者心理状态的影响[J]. 护理学杂志, 2022, 37(1): 25-29. |
[18] | 朱艳华, 靳永萍, 王培席, 等. 护理人员安宁疗护的认知及相关培训现状的研究进展[J]. 中西医结合护理(中英文), 2020, 6(10): 372-377. |
[19] | 赵霞. 护患沟通管理流程及健康教育用于急诊留观室中的临床分析[J]. 中国保健营养, 2019, 29(4): 351. |
[20] | 和芳, 何瑞仙. 安宁疗护专科护士认证和再认证发展现状[J]. 中华护理杂志, 2021, 56(4): 623-628. |
[21] | 施敏. 安宁疗护中医患双方认识误区的探讨[J]. 医学与哲学, 2022, 43(12): 49-52. https://doi.org/10.12014/j.issn.1002-0772.2022.12.11 |
[22] | 吴世菊, 龚国梅. 国内护理人员安宁疗护知信行的研究现状[J]. 护理研究, 2018, 32(21): 3372-3374. |