一个移动临终关怀护士教学团队的经验：对护理人员进行临终患者精神与存在关怀方面的培训——一项定性研究
A mobile hospice nurse teaching team's experience: training care workers in spiritual and existential care for the dying - a qualitative study.
作者信息
Tornøe Kirsten, Danbolt Lars Johan, Kvigne Kari, Sørlie Venke
机构信息
Lovisenberg Diaconal University College, Lovisenberg gt.15B, 0456, Oslo, Norway.
MF, Norwegian School of Theology, Gydas vei 4, Majorstuen, P.O. Box 5144, 0302, Oslo, Norway.
出版信息
BMC Palliat Care. 2015 Sep 18;14:43. doi: 10.1186/s12904-015-0042-y.
BACKGROUND
Nursing home and home care nursing staff must increasingly deal with palliative care challenges, due to cost cutting in specialized health care. Research indicates that a significant number of dying patients long for adequate spiritual and existential care. Several studies show that this is often a source of anxiety for care workers. Teaching care workers to alleviate dying patients' spiritual and existential suffering is therefore important. The aim of this study is to illuminate a pioneering Norwegian mobile hospice nurse teaching team's experience with teaching and training care workers in spiritual and existential care for the dying in nursing homes and home care settings.
METHODS
The team of expert hospice nurses participated in a focus group interview. Data were analyzed using a phenomenological hermeneutical method.
RESULTS
The mobile teaching team taught care workers to identify spiritual and existential suffering, initiate existential and spiritual conversations and convey consolation through active presencing and silence. The team members transferred their personal spiritual and existential care knowledge through situated "bedside teaching" and reflective dialogues. "The mobile teaching team perceived that the care workers benefitted from the situated teaching because they observed that care workers became more courageous in addressing dying patients' spiritual and existential suffering.
DISCUSSION
Educational research supports these results. Studies show that efficient workplace teaching schemes allowexpert practitioners to teach staff to integrate several different knowledge forms and skills, applying a holisticknowledge approach. One of the features of workplace learning is that expert nurses are able to guide novices through the complexities of practice. Situated learning is therefore central for becoming proficient.
CONCLUSIONS
Situated bedside teaching provided by expert mobile hospice nurses may be an efficient way to develop care workers' courage and competency to provide spiritual and existential end-of-life-care. Further research is recommended on the use of mobile expert nurse teaching teams to improve nursing competency in the primary health care sector.
背景
由于专科医疗保健领域的成本削减，养老院和家庭护理的护理人员越来越多地面临姑息治疗方面的挑战。研究表明，相当数量的临终患者渴望获得足够的精神和生存关怀。多项研究表明，这往往是护理人员焦虑的一个来源。因此，教导护理人员减轻临终患者的精神和生存痛苦非常重要。本研究的目的是阐明挪威一个开创性的移动临终关怀护士教学团队在养老院和家庭护理环境中，对护理人员进行临终精神和生存关怀教学与培训的经验。
方法
专家临终关怀护士团队参与了焦点小组访谈。使用现象学诠释学方法对数据进行分析。
结果
移动教学团队教导护理人员识别精神和生存痛苦，发起生存和精神对话，并通过积极在场和沉默来给予慰藉。团队成员通过现场“床边教学”和反思性对话传授他们个人的精神和生存关怀知识。“移动教学团队认为护理人员从现场教学中受益，因为他们观察到护理人员在应对临终患者的精神和生存痛苦时变得更加勇敢。
讨论
教育研究支持这些结果。研究表明，高效的工作场所教学方案使专家从业者能够教导员工整合多种不同的知识形式和技能，采用整体知识方法。工作场所学习的一个特点是专家护士能够指导新手应对实践中的复杂性。因此，情境学习对于熟练掌握技能至关重要。
结论
由专家移动临终关怀护士提供的现场床边教学可能是培养护理人员提供精神和生存临终关怀的勇气和能力的有效方式。建议进一步研究使用移动专家护士教学团队来提高初级卫生保健部门的护理能力。
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