McGrath Pam, Moore Alex, McNaught Meg, Palmer Gail, Greene Anne, Atkinson Dawn
School of Nursing and Health, Central Queensland University, Rockhampton, Qld 4702, Australia.
Support Care Cancer. 2005 Sep;13(9):691-701. doi: 10.1007/s00520-005-0795-6. Epub 2005 Apr 16.
The use of validated tools is increasingly accepted as an unqualified good that is viewed as best practice in supportive care. This article begins to explore the impact of standardized questionnaire use in supportive care by presenting findings from recent qualitative research on clients' perceptions of the use of standardized assessment tools during their hospice experience.
There were two arms to this phenomenological descriptive study: A. Interviews with hospice patients and their carers; B. Interviews with hospice staff. The results from arm A are reported in this article. This involved interviews with ten families (available patient and carer) who had hospice experience with questionnaires and ten families who were cared for without questionnaires. The interviews were audiorecorded, transcribed verbatim, and thematically analysed.
The research presented in this article is seminal work in the area which affirms significant concerns about the use of questionnaires in hospice practice. The evidence indicates the majority of clients dislike the use of questionnaires and points to questionnaire use being a practice built around staff, rather than client, needs. The findings also provide insight into the process of collusion by which hospice workers who are enthusiastic about the use of questionnaires can be led to believe, because of client gratitude, that the process is positive.
Questionnaires should not be seen as an unqualified good, and thus should not be automatically accepted as best practice within hospice or palliative care service provision.
使用经过验证的工具越来越被视为一种绝对的好事,被视为支持性护理中的最佳实践。本文通过展示近期定性研究的结果,探讨标准化问卷在支持性护理中的使用影响,这些研究是关于客户在临终关怀体验中对使用标准化评估工具的看法。
这项现象学描述性研究有两个分支:A. 对临终关怀患者及其护理人员进行访谈;B. 对临终关怀工作人员进行访谈。本文报告了A分支的结果。这包括对十个有问卷临终关怀体验的家庭(患者和护理人员均参与)以及十个没有问卷护理的家庭进行访谈。访谈进行了录音,逐字转录,并进行了主题分析。
本文所呈现的研究是该领域的开创性工作,证实了对临终关怀实践中使用问卷的重大担忧。证据表明,大多数客户不喜欢使用问卷,并指出问卷的使用是围绕工作人员而非客户需求建立的一种做法。研究结果还深入了解了一种勾结过程,即热衷于使用问卷的临终关怀工作者由于客户的感激之情而可能被引导相信这个过程是积极的。
问卷不应被视为绝对的好事,因此在临终关怀或姑息治疗服务提供中不应自动被接受为最佳实践。