Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada.
Cancer Nurs. 2012 Sep-Oct;35(5):374-81. doi: 10.1097/NCC.0b013e318232e237.
When a clinical culture emphasizes cure, as in bone marrow transplantation (BMT) services, BMT nurses commonly experience enormous stress when patients are suffering or dying. In this context, it is unclear what meanings BMT nurses experience in their work and how they find meaning and sustain hope, given conflicting responsibilities to patients.
This study aimed to explore BMT nurses' experiences of meaning and hope and the effects of a meaning-centered intervention (MCI) on these experiences using qualitative methodology.
Fourteen BMT nurses engaged in a 5-session MCI, with 7 members each participating in 2 groups. Semistructured qualitative interviews were conducted at 1 month before and after the intervention. Interpretive phenomenology guided data analysis.
The BMT nurses in the Princess Margaret Hospital experienced meaning in their involvement with their patients' suffering. The MCI seemed to inspire participants to engage more with patients and their suffering. Three subthemes reflected this influence: (a) greater awareness of boundaries between their personal and professional involvement, (b) enhanced empathy from an awareness of a shared mortality, and (c) elevated hope when nurses linked patients' suffering with meaning.
This study confirms that patients' suffering constitutes nurses' search for meaning and hope in their work. The MCI offers a way in which to actively support nurses in this process.
Nurses can learn to be more responsive to patients' suffering beyond limits of cure. A minimal intervention, such as the MCI, supports BMT nurses in finding positive personal meaning and purpose in their otherwise highly stressful work culture.
当临床文化强调治愈时，例如在骨髓移植（BMT）服务中，当患者遭受痛苦或死亡时，BMT 护士通常会承受巨大的压力。在这种情况下，尚不清楚 BMT 护士在工作中体验到了什么意义，以及在对患者负有相互冲突的责任的情况下，他们如何找到意义并保持希望。
本研究旨在使用定性方法探讨 BMT 护士的意义和希望体验，以及意义中心干预（MCI）对这些体验的影响。
14 名 BMT 护士参与了为期 5 次的 MCI，每次有 7 名成员，其中 7 名成员分别参加了 2 个小组。在干预前后 1 个月进行了半结构化定性访谈。解释性现象学指导了数据分析。
玛格丽特公主医院的 BMT 护士在参与患者的痛苦中体验到了意义。MCI 似乎激发了参与者更多地与患者及其痛苦接触。三个子主题反映了这种影响：（a）对个人和专业参与之间界限的认识增强；（b）通过意识到共同的死亡率而增强的同理心；（c）当护士将患者的痛苦与意义联系起来时，希望感提升。
本研究证实，患者的痛苦构成了护士在工作中寻找意义和希望的基础。MCI 为积极支持护士在这一过程中提供了一种方法。
护士可以学会在超越治愈极限的情况下更积极地回应患者的痛苦。像 MCI 这样的最小干预措施可以支持 BMT 护士在他们原本压力极大的工作文化中找到积极的个人意义和目标。
