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护士对向患者及其家属告知坏消息的看法:一项质性内容分析

Nurses' perspectives on breaking bad news to patients and their families: a qualitative content analysis.

作者信息

Abbaszadeh Abbas, Ehsani Seyyedeh Roghayeh, Begjani Jamal, Kaji Mohammad Akbari, Dopolani Fatemeh Nemati, Nejati Amir, Mohammadnejad Esmaeil

机构信息

Professor, Department of Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Nursing, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Med Ethics Hist Med. 2014 Nov 12;7:18. eCollection 2014.

Abstract

Breaking bad news is quite often not done in an effective manner in clinical settings due to the medical staff lacking the skills necessary for speaking to patients and their families. Bad news is faced with similar reactions on the part of the news receiver in all cultures and nations. The purpose of this study was to explore the perspectives of Iranian nurses on breaking bad news to patients and their families. In this research, a qualitative approach was adopted. In-depth and semi-structured interviews were conducted with 19 nurses who had at least one year work experience in the ward, and content analysis was performed to analyze the data. Five major categories emerged from data analysis, including effective communication with patients and their families, preparing the ground for delivering bad news, minimizing the negativity associated with the disease, passing the duty to physicians, and helping patients and their families make logical treatment decisions. The results of this study show that according to the participants, it is the physicians' duty to give bad news, but nurses play an important role in delivering bad news to patients and their companions and should therefore be trained in clinical and communicative skills to be able to give bad news in an appropriate and effective manner.

摘要

在临床环境中,由于医务人员缺乏与患者及其家属沟通所需的技能,传达坏消息往往无法有效进行。在所有文化和国家中,坏消息的接收者都会有类似的反应。本研究的目的是探讨伊朗护士对向患者及其家属传达坏消息的看法。在这项研究中,采用了定性研究方法。对19名在病房至少有一年工作经验的护士进行了深入的半结构化访谈,并对数据进行了内容分析。数据分析得出了五个主要类别,包括与患者及其家属进行有效沟通、为传达坏消息做好铺垫、尽量减少与疾病相关的负面影响、将责任转交给医生以及帮助患者及其家属做出合理的治疗决策。这项研究的结果表明,根据参与者的说法,传达坏消息是医生的职责,但护士在向患者及其同伴传达坏消息方面起着重要作用,因此应该接受临床和沟通技能培训,以便能够以适当和有效的方式传达坏消息。

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Iran Red Crescent Med J. 2014 Jun;16(6):e8197. doi: 10.5812/ircmj.8197. Epub 2014 Jun 5.
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