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在中国文化背景下照顾临终癌症患者:一项从医生和护士视角开展的定性研究。

Caring for dying cancer patients in the Chinese cultural context: A qualitative study from the perspectives of physicians and nurses.

作者信息

Dong Fengqi, Zheng Ruishuang, Chen Xuelei, Wang Yanhui, Zhou Hongyuan, Sun Rong

机构信息

Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.

Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.

出版信息

Eur J Oncol Nurs. 2016 Apr;21:189-96. doi: 10.1016/j.ejon.2015.10.003. Epub 2015 Nov 5.

Abstract

OBJECTIVE

To explore the experiences of Chinese physicians and nurses who care for dying cancer patients in their practical work.

METHOD

This was a qualitative study using semi-structured face-to-face interviews. Fifteen physicians and 22 nurses were recruited from a cancer center in mainland China. The data were analyzed by qualitative thematic analysis.

RESULTS

Disclosure of information on death and cancer to dying cancer patients is taboo in traditional Chinese culture, which greatly decreases the physicians' and nurses' effective communication with dying patients in end-of-life (EOL) care. Both physicians and nurses described strong ambitions to give dying cancer patients high-quality care, and they emphasized the importance of maintaining dying patients' hopes in the death-denying cultural context. However, the nurses were more concerned with dying patients' physical comfort and wish fulfillment, while the physicians placed greatest emphasis on patients' rights and symptom management. Both physicians and nurses suffered whilst also benefitting from taking care of dying patients which helped with their personal growth and allowed greater insight into themselves and their clinical practice. Our results also indicated that Chinese physicians and nurses require improved methods of communication on EOL care, as well as needing more support to provide quality EOL care.

CONCLUSION

Chinese physicians and nurses experience a challenge when caring for dying cancer patients in the Chinese cultural context. Flexible and specific education and training in EOL cancer care are required to meet the needs of Chinese physicians and nurses at the cancer center studied.

摘要

目的

探讨中国大陆的医生和护士在实际工作中照顾临终癌症患者的经历。

方法

这是一项采用半结构化面对面访谈的定性研究。从中国大陆的一家癌症中心招募了15名医生和22名护士。采用定性主题分析法对数据进行分析。

结果

在中国传统文化中,向临终癌症患者透露死亡和癌症信息是禁忌,这极大地减少了医生和护士在临终关怀(EOL)中与临终患者的有效沟通。医生和护士都表达了为临终癌症患者提供高质量护理的强烈愿望,他们强调在否认死亡的文化背景下维持临终患者希望的重要性。然而,护士更关注临终患者的身体舒适和愿望实现,而医生则最强调患者的权利和症状管理。照顾临终患者让医生和护士既承受痛苦,也从中受益,这有助于他们的个人成长,并让他们对自己和临床实践有更深刻的认识。我们的结果还表明,中国医生和护士在临终关怀方面需要改进沟通方法,也需要更多支持来提供高质量的临终关怀。

结论

在中国文化背景下,中国医生和护士在照顾临终癌症患者时面临挑战。需要开展灵活且具体的临终癌症护理教育培训,以满足所研究癌症中心中国医生和护士的需求。

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