Clayton Margaret F, Reblin Maija, Carlisle McKenzie, Ellington Lee
College of Nursing, University of Utah in Salt Lake City.
School of Medicine, University of Utah in Salt Lake City.
Oncol Nurs Forum. 2014 May;41(3):311-21. doi: 10.1188/14.ONF.311-321.
PURPOSE/OBJECTIVES: To identify and describe communication behaviors used by hospice nurses when eliciting and addressing concerns of patients with cancer and their caregivers.
Secondary analysis.
Home hospice in Salt Lake City, UT.
Audio recordings from seven patient and caregiver dyads and five hospice nurses.
Audio recordings were coded using the Roter Interaction Analysis System for patient and caregiver concern statements indicating negative affect and distress and the surrounding nurse communication behaviors. Concern content was categorized using domains developed by the National Consensus Project for Quality Palliative Care.
Patient and caregiver concern statements and nurse communication behaviors.
180 patient and caregiver speaking turns containing concerns were identified across 31 hospice visits. Patients and caregivers expressed at least one concern in the vast majority of visits. The most prevalent distress areas reflected psychological and physical issues. Nurses used proportionally more positive emotion statements before patient and caregiver concerns, compared to the visit overall. Nurses asked proportionally more physical questions after concern statements. Nurses also used more emotional responses before and after patient and caregiver concerns, relative to the entire visit.
Patients with cancer and caregivers frequently talk about distressing issues. Hospice nurses use specific communication behaviors to elicit and address those issues.
Home hospice provides a venue to examine nurse communication behaviors used to elicit and respond to patient and caregiver distress. These strategies could be taught to nurses who encounter patient distress less frequently or are less comfortable with emotional conversations.
目的/目标：识别并描述临终关怀护士在引出和处理癌症患者及其照护者的担忧时所使用的沟通行为。
二次分析。
犹他州盐湖城的家庭临终关怀机构。
来自7对患者与照护者以及5名临终关怀护士的音频记录。
使用罗特尔互动分析系统对音频记录进行编码，以识别患者和照护者表示负面影响和痛苦的担忧陈述以及周围的护士沟通行为。担忧内容根据全国姑息治疗质量共识项目制定的领域进行分类。
患者和照护者的担忧陈述以及护士的沟通行为。
在31次临终关怀访视中，共识别出180次包含担忧的患者和照护者发言轮次。在绝大多数访视中，患者和照护者表达了至少一种担忧。最普遍的痛苦领域反映了心理和身体问题。与总体访视相比，护士在患者和照护者表达担忧之前使用的积极情绪陈述比例更高。在担忧陈述之后，护士提出的身体问题比例更高。相对于整个访视，护士在患者和照护者表达担忧之前和之后也使用了更多的情感回应。
癌症患者及其照护者经常谈论令人痛苦的问题。临终关怀护士使用特定的沟通行为来引出和处理这些问题。
家庭临终关怀提供了一个场所，可用于检查护士在引出和回应患者及照护者痛苦时所使用的沟通行为。这些策略可以传授给那些较少遇到患者痛苦或对情感对话不太自在的护士。
