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遗传专业人员的悲伤和失落体验:对支持和培训的启示。

Genetics professionals' experiences with grief and loss: implications for support and training.

机构信息

Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA.

出版信息

Clin Genet. 2010 May;77(5):421-9. doi: 10.1111/j.1399-0004.2010.01409.x.

Abstract

This study was designed to determine the degree to which clinical genetics professionals are comfortable with grief and loss, whether discomfort with grief and loss is associated with clinician distress, and what factors predict comfort with grief and loss for the purpose of developing recommendations for support and training. We surveyed 300 clinical geneticists (MDs), genetic counselors (GCs) and genetic nurses randomly selected from their professional associations. Out of 225 eligible clinicians, 172 completed surveys (76% response rate). The vast majority of respondents have clinical interactions with patients and families who are experiencing grief, loss and/or death. However, nearly 20% of respondents reported that they did not feel 'comfortable in the presence of grief and loss'. Twenty-nine percent of respondents disagree or strongly disagree that they 'have been adequately trained to address issues of death, dying, grief/bereavement, and end of life care'. Reported discomfort with grief and loss was strongly correlated with clinician distress. Predictors of comfort with grief and loss included perceived adequacy of training, tolerance for uncertainty, significant personal experiences of loss and deriving meaning from patient care. In conclusion, as follows. A significant minority of clinical genetics professionals experience discomfort in the presence of grief and loss, and feel inadequately prepared for such experiences. Greater attention should be paid to training clinicians in how to deal with grief and loss, and supporting them through such difficult experiences in an effort to reduce their distress.

摘要

本研究旨在确定临床遗传学专业人员对悲伤和失落的适应程度,不适应悲伤和失落是否与临床医生的困扰有关,以及哪些因素可以预测对悲伤和失落的适应程度,从而为支持和培训制定建议。我们随机从专业协会中抽取了 300 名临床遗传学家(MD)、遗传咨询师(GC)和遗传护士进行调查。在 225 名符合条件的临床医生中,有 172 名完成了调查(76%的回复率)。绝大多数受访者与正在经历悲伤、失落和/或死亡的患者及其家属有临床接触。然而,近 20%的受访者表示,他们在悲伤和失落面前感到“不舒服”。29%的受访者不同意或强烈不同意他们“接受过充分的培训来解决死亡、临终、悲伤/丧亲、以及临终关怀等问题”。报告的悲伤和失落不适与临床医生的困扰密切相关。对悲伤和失落的适应程度的预测因素包括培训的充足程度、对不确定性的容忍度、个人经历的重大损失以及从患者护理中获得的意义。综上所述。相当一部分临床遗传学专业人员在面对悲伤和失落时感到不适,并且对这些经历感到准备不足。应该更加关注培训临床医生如何处理悲伤和失落,并在他们经历这些困难时给予支持,以减少他们的困扰。

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