Browall Maria, Henoch Ingela, Melin-Johansson Christina, Strang Susann, Danielson Ella
School of Health and Education, University of Skövde, Sweden; Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
University of Gothenburg, The Sahlgrenska Academy, Institute of Health and Care Sciences, Box 457, SE-405 30 Göteborg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Sweden.
Eur J Oncol Nurs. 2014 Dec;18(6):636-44. doi: 10.1016/j.ejon.2014.06.001. Epub 2014 Jul 1.
Nurses working with cancer patients in end of life care need to be prepared to encounter patients' psychosocial and spiritual distress.
The aim of this study was to describe nurses' experiences of existential situations when caring for patients severely affected by cancer.
Nurses (registered and enrolled) from three urban in-patient hospices, an oncology clinic and a surgery clinic and a palliative homecare team were, prior to the start of a training program, invited to write down their experiences of a critical incident (CI), in which existential issues were featured.
Eighty-eight CIs were written by 83 nurses. The CIs were analyzed with qualitative content analysis. Two main themes were found: Encounters with existential pain experiences, which concerned facing death and facing losses; and Encountering experiences of hope, which concerned balancing honesty, and desire to live.
This study points out that health care professionals need to be aware of patients' feelings of abandonment in exposed situations such as patients' feelings of existential loneliness. That there are some patients that express a desire to die and this makes the nurses feel uncomfortable and difficult to confront these occurrences and its therefore important to listen to patients' stories, regardless of care organization, in order to gain access to patients' inner existential needs.
从事癌症患者临终关怀工作的护士需要做好准备，应对患者的心理社会和精神痛苦。
本研究旨在描述护士在照顾受癌症严重影响的患者时，对生存状况的体验。
来自三个城市住院临终关怀机构、一个肿瘤诊所、一个外科诊所和一个姑息家庭护理团队的护士（注册护士和在册护士），在一个培训项目开始前，被邀请写下他们在一次关键事件（CI）中的经历，其中存在一些生存问题。
83名护士写下了88个关键事件。采用定性内容分析法对关键事件进行分析。发现了两个主要主题：与生存痛苦经历的相遇，涉及面对死亡和面对损失；以及与希望经历的相遇，涉及平衡诚实和生存欲望。
本研究指出，医护人员需要意识到患者在诸如生存孤独感等暴露情况下的被遗弃感。有些患者表达了想死的愿望，这让护士感到不舒服，难以应对这些情况，因此，无论护理机构如何，倾听患者的故事以了解患者内心的生存需求非常重要。
