Olsman Erik, Duggleby Wendy, Nekolaichuk Cheryl, Willems Dick, Gagnon Judith, Kruizinga Renske, Leget Carlo
Section of Medical Ethics, Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
J Pain Symptom Manage. 2014 Nov;48(5):831-8.e2. doi: 10.1016/j.jpainsymman.2014.02.008. Epub 2014 Apr 18.
Hope is important in palliative care. However, palliative care professionals' perspectives on hope are not well understood. Metaphors of hope are a way of better understanding these perspectives.
To describe palliative care professionals' perspectives on hope by examining the hope metaphors they spontaneously used to describe their own hope and their perspectives on the hope of patients and their families.
Semistructured interviews with palliative care professionals were recorded, transcribed, and analyzed using a narrative approach. Results were discussed until the researchers reached consensus and reinforced by other health-care professionals and by observing several palliative care settings.
The 64 participants (mean (SD) age, 48.42 (9.27) years and 72% female) were physicians (41%), nurses (34%), chaplains (20%), or other professionals (5%), working in Canada (19%) or The Netherlands (81%). Participants described the hope of patients, their families, or themselves as a 1) grip, which implied safety; 2) source, which implied strength; 3) tune, which implied harmony; and 4) vision, which implied a positive perspective. Compared with Dutch participants, Canadian participants generally put more emphasis on spirituality and letting go of their own hope as a grip (safety). Compared with other included professionals, physicians used hope as a grip (safety) most often, whereas chaplains used hope as a tune (harmony) most often.
Our findings help to increase the understanding of hope and contribute to improving communication skills in palliative care professionals.
希望在姑息治疗中很重要。然而，人们对姑息治疗专业人员对希望的看法了解并不充分。希望的隐喻是更好理解这些看法的一种方式。
通过研究姑息治疗专业人员自发用来描述自身希望以及他们对患者及其家属希望的看法的希望隐喻，来描述他们对希望的看法。
采用叙事方法对姑息治疗专业人员进行半结构化访谈，并对访谈进行录音、转录和分析。研究人员对结果进行讨论，直至达成共识，并得到其他医疗保健专业人员的支持以及通过观察多个姑息治疗环境得到强化。
64名参与者（平均（标准差）年龄为48.42（9.27）岁，72%为女性）为医生（41%）、护士（34%）、牧师（20%）或其他专业人员（5%），他们在加拿大工作（19%）或荷兰工作（81%）。参与者将患者、其家属或他们自己的希望描述为：1）“紧握”，意味着安全；2）“源泉”，意味着力量；3）“曲调”，意味着和谐；4）“愿景”，意味着积极的观点。与荷兰参与者相比，加拿大参与者通常更强调灵性以及放下作为“紧握”（安全）的自身希望。与其他纳入的专业人员相比，医生最常将希望描述为“紧握”（安全），而牧师最常将希望描述为“曲调”（和谐）。
我们的研究结果有助于增进对希望的理解，并有助于提高姑息治疗专业人员的沟通技巧。
