Muggleton Joshua, Guy Helen, Howard Ruth
School of Psychology, University of Birmingham, Birmingham, UK.
Birmingham and Solihull Mental Health NHS Foundation Trust, Heart of England NHS Foundation Trust, Birmingham, UK.
BMJ Support Palliat Care. 2015 Jun;5(2):189-95. doi: 10.1136/bmjspcare-2014-000698. Epub 2014 Oct 8.
Disgusting symptoms are common in healthcare settings. Previous research has identified that healthcare professionals systematically avoid contact with patients with disgusting symptoms, potentially compromising patient care. Furthermore, research has highlighted disgust in healthcare professionals as a possible contributory factor to dehumanisation and abuse of patients. Given that healthcare professionals often feel that disgust is unprofessional, they may also feel unable to express or process disgust in their work, potentially impacting their emotional health, and contributing to burning out. Given the ubiquity of disgust in palliative care, we investigated how palliative healthcare professionals' experience and cope with disgust in their work, and how they are supported in doing so.
We interviewed six palliative healthcare professionals and analysed their transcripts using Interpretative Phenomenological Analysis, from which four themes are discussed.
Three key findings emerged. Firstly, participants were uncomfortable talking about disgust at work, reducing their access to support for disgust. Secondly, participants often neglected their own emotional needs, and as a result, sometimes become emotionally entangled with patients. Finally, participants were at risk of reducing vital socio-emotional support for patients with disgusting symptoms. Based on our analysis, we suggest interventions to counteract these effects.
令人厌恶的症状在医疗环境中很常见。先前的研究表明,医护人员会系统性地避免与有令人厌恶症状的患者接触,这可能会损害患者护理。此外,研究还强调医护人员的厌恶情绪可能是导致对患者非人化和虐待的一个因素。鉴于医护人员常常觉得厌恶情绪是不专业的,他们可能也会觉得在工作中无法表达或处理这种情绪,这可能会影响他们的情绪健康,并导致职业倦怠。鉴于厌恶情绪在姑息治疗中普遍存在,我们调查了姑息治疗医护人员在工作中如何体验和应对厌恶情绪,以及他们在这方面得到了哪些支持。
我们采访了六位姑息治疗医护人员,并使用解释现象学分析方法对他们的访谈记录进行了分析,在此基础上讨论了四个主题。
出现了三个关键发现。首先,参与者在工作中谈论厌恶情绪时感到不自在,这减少了他们获得应对厌恶情绪支持的机会。其次,参与者常常忽视自己的情感需求,结果有时会与患者产生情感纠葛。最后,参与者有可能减少对有令人厌恶症状患者至关重要的社会情感支持。基于我们的分析,我们提出了一些干预措施来抵消这些影响。