Wittenberg Elaine, Ragan Sandra L, Ferrell Betty
1 Division of Nursing Research and Education, City of Hope National Medical Center, Duarte, CA, USA.
2 Department of Communication, University of Oklahoma, Norman, OK, USA.
Am J Hosp Palliat Care. 2017 Jul;34(6):566-571. doi: 10.1177/1049909116641630. Epub 2016 Mar 31.
Although spiritual care is considered one of the pillars of palliative care, many health-care providers never receive formal training on how to communicate about spirituality with patients and families. The aim of this study was to explore the spiritual care experiences of oncology nurses in order to learn more about patient needs and nurse responses.
A survey was circulated at a communication training course for oncology nurses in June 2015. Nurses recalled a care experience that included the initiation of a spiritual care topic and their response to the patient/family. Data were analyzed using thematic analysis.
Nurses reported that communication about spirituality was primarily initiated by patients, rather than family members, and spiritual topics commonly emerged during the end of life or when patients experienced spiritual distress. Nurses' experiences highlighted the positive impact spiritual conversations had on the quality of patient care and its benefit to families. Spiritual communication was described as an important nursing role at the end of patients' lives, and nonverbal communication, listening, and discussing patients' emotions were emphasized as important and effective nurse communication skills during spiritual care conversations. Approximately one-third of nurses in the sample reported sharing their own personal spiritual or religious backgrounds with patients, and they reported that these sharing experiences strengthened their own faith.
It is evident that patients want to discuss spiritual topics during care. Study findings illustrate the need to develop a spiritual communication curriculum and provide spiritual care communication training to clinicians.
尽管精神关怀被视为姑息治疗的支柱之一，但许多医疗保健提供者从未接受过关于如何与患者及其家属就精神层面进行沟通的正规培训。本研究的目的是探索肿瘤护理人员的精神关怀经历，以便更多地了解患者需求和护理人员的应对措施。
2015年6月，在一次针对肿瘤护理人员的沟通培训课程上发放了一份调查问卷。护理人员回忆一次包含开启精神关怀话题以及他们对患者/家属的应对措施的护理经历。采用主题分析法对数据进行分析。
护理人员报告称，关于精神层面的沟通主要由患者发起，而非家属，且精神层面的话题通常在生命末期或患者经历精神痛苦时出现。护理人员的经历凸显了精神层面的对话对患者护理质量产生的积极影响及其对家属的益处。精神层面的沟通被描述为患者生命末期一项重要的护理职责，在精神关怀对话中，非语言沟通、倾听以及讨论患者的情绪被强调为重要且有效的护理人员沟通技巧。样本中约三分之一的护理人员报告称与患者分享了自己个人的精神或宗教背景，且他们表示这些分享经历强化了自身的信仰。
显然，患者希望在护理期间讨论精神层面的话题。研究结果表明有必要开发一门精神沟通课程，并为临床医生提供精神关怀沟通培训。
