Pavlish Carol, Ceronsky Lyn
School of Nursing, University of California, Los Angeles, CA, USA.
Clin J Oncol Nurs. 2009 Aug;13(4):404-12. doi: 10.1188/09.CJON.404-412.
Managing symptoms, providing information, and supporting families as well as patients are key aspects of palliative care. However, palliative care definitions and perspectives vary widely in clinical practice and often do not align with palliative care organizations' perspectives. Definitional discrepancies may result in delayed referrals and role confusion, which often limit the effectiveness of palliative care programs and contribute to gaps in care and services for patients and their families. The aim of this research study was to explore oncology nurses' perspectives of palliative care through narrative analysis of participants' descriptions of life experiences. Studying nurses' perceptions of their roles in palliative care offers an opportunity to examine and improve clinical practice. Nine focus groups were conducted with 33 oncology nurses in three medical centers in the midwestern region of the United States. Researchers inductively coded research text within each focus group session, sorted across sessions using Atlas.ti 5.2 software, and then applied categorical-content narrative analysis. Findings revealed five primary nursing roles: teaching, caring, coordinating, advocating, and mobilizing. In all five roles, seven professional attributes were described: clinical expertise, honesty, family orientation, perceptive attentiveness, presence, collaboration, and deliberateness. Integrating palliative care standards into role and attribute development and working with palliative care specialty teams are suggested.
控制症状、提供信息以及支持患者及其家属是姑息治疗的关键方面。然而，姑息治疗的定义和观点在临床实践中差异很大，且往往与姑息治疗组织的观点不一致。定义上的差异可能导致转诊延迟和角色混淆，这常常会限制姑息治疗项目的有效性，并造成患者及其家属在护理和服务方面的差距。本研究的目的是通过对参与者生活经历描述的叙事分析，探讨肿瘤护理人员对姑息治疗的看法。研究护士对其在姑息治疗中角色的认知，为审视和改进临床实践提供了一个机会。在美国中西部地区的三个医疗中心，对33名肿瘤护理人员进行了9个焦点小组访谈。研究人员在每个焦点小组会议中对研究文本进行归纳编码，使用Atlas.ti 5.2软件在各会议间进行分类整理，然后应用分类内容叙事分析。研究结果揭示了五个主要的护理角色：教学、关怀、协调、倡导和动员。在所有这五个角色中，描述了七种专业属性：临床专业知识、诚实、以家庭为导向、敏锐专注、陪伴、协作和审慎。建议将姑息治疗标准纳入角色和属性发展，并与姑息治疗专业团队合作。
