Mahon Margaret M, McAuley William J
School of Nursing, College of Health and Human Services, George Mason University, Fairfax, VA, USA.
Oncol Nurs Forum. 2010 May;37(3):E141-50. doi: 10.1188/10.ONF.E141-E150.
PURPOSE/OBJECTIVES: To examine how oncology nurses define palliative care, views about who should and should not receive palliative care, and beliefs about palliative care decision making, including who should be involved and how decisions should be managed.
Qualitative interviews and analysis.
Preferred location of each respondent.
12 nurses representing different aspects of oncology nursing.
An interview guide was employed to ensure that specific topics were covered. Interviews were transcribed verbatim. Qualitative analysis consisted of independent, multiple reviews of the transcripts to share initial findings and identify, refine, and reach consensus on major themes and subthemes.
Nurses' definitions of palliative care, views about who should and should not receive palliative care, and beliefs about palliative care decision making.
Nurses' perceptions of palliative care focused on symptom management. Most did not distinguish between palliative care and hospice and believed that only patients who were near the end of life should receive palliative care. They viewed their role in decisions regarding palliative care to be limited and indirect.
Although oncology nurses should be at the cutting edge with regard to palliative care, these nurses' personal understandings could serve to limit care for many patients with cancer who could benefit from it.
Education and clinical experience embedded in a continuous quality-improvement model are needed to ensure sustained change that will overcome the multiple, interwoven barriers to providing appropriate palliative care.
目的/目标：探讨肿瘤护理人员如何定义姑息治疗，对哪些患者应该以及不应该接受姑息治疗的看法，以及对姑息治疗决策的信念，包括应该由谁参与以及如何管理决策。
定性访谈与分析。
每位受访者选择的地点。
12名代表肿瘤护理不同方面的护士。
采用访谈指南以确保涵盖特定主题。访谈逐字记录。定性分析包括对记录进行独立、多次审查，以分享初步发现，并就主要主题和子主题进行识别、完善并达成共识。
护士对姑息治疗的定义、对哪些患者应该以及不应该接受姑息治疗的看法，以及对姑息治疗决策的信念。
护士对姑息治疗的认知集中在症状管理上。大多数人没有区分姑息治疗和临终关怀，认为只有临终患者才应接受姑息治疗。他们认为自己在姑息治疗决策中的作用有限且间接。
尽管肿瘤护理人员在姑息治疗方面应处于前沿，但这些护士的个人理解可能会限制许多能从中受益的癌症患者获得护理。
需要将教育和临床经验融入持续质量改进模式，以确保实现持续变革从而克服提供适当姑息治疗的多重交织障碍。
