全科医生对宗教信仰及在佛兰德斯的姑息治疗中使用 FICA 工具的看法：一项定性研究。
GPs' views concerning spirituality and the use of the FICA tool in palliative care in Flanders: a qualitative study.
机构信息
Katholieke Universiteit Leuven, Department of General Practice, Leuven, Belgium.
出版信息
Br J Gen Pract. 2012 Oct;62(603):e718-25. doi: 10.3399/bjgp12X656865.
BACKGROUND
According to recent recommendations, healthcare professionals in palliative care should be able to perform a spiritual history-taking. Previous findings suggest that the FICA tool is feasible for the clinical assessment of spirituality. However, little is known about the views of GPs on the use of this tool.
AIM
To provide a solid overview of the views of Flemish GPs concerning spirituality and the use of the FICA tool for spiritual history-taking in palliative care.
DESIGN AND SETTING
Qualitative interview study in Flanders, Belgium.
METHOD
Twenty-three GPs participated in a semi-structured interview. The interviews were analysed by thematic analysis, which includes line-by-line coding and the generation of descriptive and analytical themes.
RESULTS
The interviewees stated that they would keep in mind the questions of the FICA tool while having a spiritual conversation, but not use them as a checklist. The content of the tool was generally appreciated as relevant, however, many GPs found the tool too structured and prescribed, and that it limited their spontaneity. They suggested rephrasing the questions into spoken language. The perceived barriers during spiritual conversations included feelings of discomfort and fear, and the lack of time and specific training. Factors that facilitated spiritual conversations included the patients' acceptance of their diagnosis, a trusting relationship, and respect for the patients' beliefs.
CONCLUSION
A palliative care process with attention focused on the patient's spirituality was generally perceived as a tough but rewarding experience. The study concludes that the FICA tool could be a feasible instrument for the clinical assessment of spirituality, provided that certain substantive and linguistic adjustments are made. Additional research is needed to find the most suitable model for spiritual history-taking, in response to the specific needs of GPs.
背景
根据最近的建议，姑息治疗中的医疗保健专业人员应该能够进行精神病史采集。先前的研究结果表明，FICA 工具可用于对灵性进行临床评估。然而，人们对全科医生对使用该工具的看法知之甚少。
目的
提供对佛兰芒全科医生对灵性的看法以及在姑息治疗中使用 FICA 工具进行精神病史采集的看法的全面概述。
设计和设置
在比利时佛兰德斯进行的定性访谈研究。
方法
23 名全科医生参加了半结构化访谈。通过主题分析对访谈进行分析，其中包括逐行编码以及生成描述性和分析性主题。
结果
受访者表示，他们在进行精神对话时会记住 FICA 工具的问题，但不会将其用作清单。该工具的内容通常被认为是相关的，但是许多全科医生发现该工具过于结构化和规定，限制了他们的自发性。他们建议将问题重新表述为口语。在精神对话中感知到的障碍包括不适感和恐惧感，以及缺乏时间和特定的培训。促进精神对话的因素包括患者对诊断的接受、信任的关系以及对患者信仰的尊重。
结论
一个关注患者灵性的姑息治疗过程通常被认为是一次艰难但有益的体验。该研究得出结论，FICA 工具可以作为评估灵性的一种可行工具，前提是对其进行某些实质性和语言上的调整。需要进一步的研究来找到最适合的精神病史采集模型，以满足全科医生的特定需求。
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