Dalgaard Karen Marie, Thorsell Georg, Delmar Charlotte
Aalborg Hospital, Aarhus University Hospital, Denmark.
Int J Palliat Nurs. 2010 Feb;16(2):87-92. doi: 10.12968/ijpn.2010.16.2.46754.
This article describes the significance of the identification and explicit communication of the different clinical phases in incurable illness trajectories in a hospital setting. The article is part of a qualitative study carried out in a Danish haematology department. The data were obtained through a total of 157 hours of participant observation and informal interviews with patients, families, doctors and nurses and four focus group interviews with doctors and nursing staff. Grounded theory was applied for the data analysis. The findings outline how the unpredictability of certain haematological malignancies and barriers in professional practice tended to postpone identifications of transitions between clinical phases. The study has identified ten barriers including personal, professional, time-related, cultural and organizational-for an open dialogue between staff, patients and families about illness progression. The quality of palliative care was affected as different clinical phases require different treatment and care strategies. Complex intervention is called for.
本文描述了在医院环境中识别和明确沟通不治之症病程中不同临床阶段的重要性。本文是在丹麦血液科进行的一项定性研究的一部分。数据通过总共157小时的参与观察、与患者、家属、医生和护士的非正式访谈以及与医生和护理人员的四次焦点小组访谈获得。数据分析采用扎根理论。研究结果概述了某些血液系统恶性肿瘤的不可预测性和专业实践中的障碍如何倾向于推迟临床阶段之间转变的识别。该研究确定了包括个人、专业、时间相关、文化和组织方面在内的十个障碍，以促进工作人员、患者和家属之间就疾病进展进行开放对话。由于不同的临床阶段需要不同的治疗和护理策略，姑息治疗的质量受到影响。因此需要进行复杂的干预。
