Trovo de Araujo Monica Martins, Paes da Silva Maria Julia
Nurse School of Universidade de Sao Paulo, Brazil.
J Clin Nurs. 2004 Feb;13(2):143-9. doi: 10.1046/j.1365-2702.2003.00862.x.
This study aimed to assess whether nurses working in intensive care units view the establishment of communication with patients beyond therapeutic possibilities as an effective palliative therapeutic resource, and which aspects of this communication they valued most.
Data were collected in November 2002, by semi-structured interviews with 10 nurses of both clinical and surgical intensive care unit at a school hospital in Sao Paulo city, Brazil. Interviews were recorded and transcribed to be further analysed according to the qualitative methodology of content analysis.
Four categories of thematic order raised from the collected statements, which clarify (i) the value of communication with terminal patients; (ii) the obstacles found during this process; (iii) the need to identify the individual demands of each patient, (iv) be able to use communication as a tool in the palliative care of the dying patient.
In conclusion, we found that the nurses working at the intensive care unit do consider communication with dying patients an effective therapeutic resource, in spite of their own difficulties in communicating with dying patients, viewing themselves as ill prepared to the task, and often, distancing themselves from the dying patients because of their inability to deal with their own feelings, which were brought forth by the confrontation with the imminence of death.
Although the number of interviewed nurses in our study was small, the results corroborated the findings of other studies and revealed an educational aspect in nursing training that deserves serious consideration.
本研究旨在评估重症监护病房的护士是否将与患者建立超越治疗可能性的沟通视为一种有效的姑息治疗资源，以及他们最看重这种沟通的哪些方面。
2002年11月，通过对巴西圣保罗市一家教学医院临床和外科重症监护病房的10名护士进行半结构式访谈收集数据。访谈进行了录音并转录，以便根据内容分析的定性方法进行进一步分析。
从收集到的陈述中归纳出四类主题顺序，它们阐明了：（i）与晚期患者沟通的价值；（ii）在此过程中发现的障碍；（iii）识别每个患者个体需求的必要性；（iv）能够将沟通用作临终患者姑息治疗的工具。
总之，我们发现重症监护病房的护士确实认为与临终患者的沟通是一种有效的治疗资源，尽管他们在与临终患者沟通方面存在自身困难，认为自己对这项任务准备不足，而且由于无法应对因直面死亡临近而产生的自身感受，常常与临终患者保持距离。
尽管我们研究中访谈的护士数量较少，但结果证实了其他研究的发现，并揭示了护理培训中一个值得认真考虑的教育方面。
