Weil Jennifer, Weiland Tracey J, Lane Heather, Jelinek George A, Boughey Mark, Marck Claudia H, Philip Jennifer
Centre for Palliative Care, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
Emergency Practice Innovation Centre, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.
Palliat Med. 2015 Apr;29(4):293-301. doi: 10.1177/0269216314560801. Epub 2015 Jan 29.
The understanding of what palliative care is, and which patients may benefit from palliative care, has important implications for optimal patient care in all areas of health provision.
To explore the understanding of palliative care by healthcare professionals caring for patients with advanced cancer attending emergency departments.
Qualitative study, with two phases: the first, a series of focus groups with healthcare professionals from various disciplines and settings caring for patients with advanced cancer presenting to emergency departments; the second, semi-structured telephone interviews with emergency healthcare professionals across Australian States and Territories, including outside metropolitan centers. The data were audio-recorded and transcribed, with analysis undertaken using a qualitative thematic analysis.
SETTING/PARTICIPANTS: Saturation of themes was reached after 8 focus groups (22 emergency nurses, 21 emergency physicians, 6 oncologists, 6 hospital palliative care clinicians, and 28 community palliative care clinicians) and 11 telephone interviews (8 emergency physicians and 3 emergency nurses), a total of 94 participants.
The overarching theme was that healthcare professionals held contradictory understandings of palliative care and its application in the emergency department; subthemes highlighted these inconsistencies when the term "palliative" is used, in understandings of and engagement with palliative care services and in perceptions about the practical utility of palliative care.
There are entrenched contradictions and tensions surrounding the term "palliative care"; confronting these is likely to require more than re-branding, and will promote better care for this vulnerable patient group in the emergency department.
了解姑息治疗是什么以及哪些患者可能从姑息治疗中受益，对于卫生保健各个领域的最佳患者护理具有重要意义。
探讨在急诊科照料晚期癌症患者的医护人员对姑息治疗的理解。
定性研究，分为两个阶段：第一阶段，与来自不同学科和机构、照料前往急诊科的晚期癌症患者的医护人员进行一系列焦点小组讨论；第二阶段，对澳大利亚各州和领地（包括大城市中心以外地区）的急诊医护人员进行半结构式电话访谈。数据进行了录音和转录，并采用定性主题分析法进行分析。
背景/参与者：在8个焦点小组（22名急诊护士、21名急诊医生、6名肿瘤学家、6名医院姑息治疗临床医生和28名社区姑息治疗临床医生）和11次电话访谈（8名急诊医生和3名急诊护士）后达到了主题饱和，共有94名参与者。
总体主题是医护人员对姑息治疗及其在急诊科的应用存在相互矛盾的理解；子主题突出了在使用“姑息”一词时、对姑息治疗服务的理解和参与以及对姑息治疗实际效用的看法方面的这些不一致之处。
围绕“姑息治疗”一词存在根深蒂固的矛盾和紧张关系；解决这些问题可能需要的不仅仅是重新命名，还将促进在急诊科为这一脆弱患者群体提供更好的护理。
