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儿科肿瘤学家应对患者死亡的策略。

Pediatric oncologists' coping strategies for dealing with patient death.

作者信息

Granek Leeat, Barrera Maru, Scheinemann Katrin, Bartels Ute

机构信息

a Department of Public Health , Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer Sheva , Israel.

b Department of Psychology and Hematology/Oncology Program , Sick Kids Hospital and Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada.

出版信息

J Psychosoc Oncol. 2016;34(1-2):39-59. doi: 10.1080/07347332.2015.1127306. Epub 2016 Feb 11.

Abstract

This research examined pediatric oncologists coping strategies when their patients died of cancer. Twenty-one pediatric oncologists at 2 Canadian pediatric academic hospitals were interviewed about their coping strategies when patients died or were in the process of dying. The grounded theory method of data collection and data analysis were used. Line-by-line coding was used to establish codes and themes and constant comparison was used to establish relations among emerging codes and themes. Pediatric oncologists used engagement coping strategies with primary and secondary responses including emotional regulation (social support and religion), problem solving (supporting families at end of life), cognitive restructuring (making a difference and research), and distraction (breaks, physical activity, hobbies and entertainment, spending time with own children). They also used disengagement coping strategies that included voluntary avoidance (compartmentalization and withdrawing from families at end of life). Given the chronic nature of patient death in pediatric oncology and the emotionally difficult nature of this work, medical institutions such as hospitals have a responsibility to assist pediatric oncologists in coping with this challenging aspect of their work. Future research is needed to evaluate how best to implement these changes on the institutional level to help oncologists cope with patient death and the effect of using these strategies on their quality of life.

摘要

本研究考察了儿科肿瘤医生在其患者死于癌症时的应对策略。对加拿大两家儿科教学医院的21名儿科肿瘤医生就患者死亡或濒死时他们的应对策略进行了访谈。采用扎根理论方法进行数据收集和数据分析。逐行编码用于建立代码和主题,持续比较用于建立新出现的代码和主题之间的关系。儿科肿瘤医生采用参与性应对策略,包括主要和次要反应,如情绪调节(社会支持和宗教)、解决问题(在生命末期支持家庭)、认知重构(有所作为和开展研究)以及分散注意力(休息、体育活动、爱好和娱乐、与自己的孩子共度时光)。他们还采用了脱离性应对策略,包括主动回避(划分界限和在生命末期与家庭脱离)。鉴于儿科肿瘤学中患者死亡的慢性性质以及这项工作在情感上的艰难性质,医院等医疗机构有责任协助儿科肿瘤医生应对其工作中这一具有挑战性的方面。需要开展进一步研究,以评估如何在机构层面上最好地实施这些变革,帮助肿瘤医生应对患者死亡问题以及这些策略对他们生活质量的影响。

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