Whitehead Phyllis B, Clark Rebecca C
Carilion Roanoke Memorial Hospital, Roanoke, VA, USA; Virginia Tech Carilion, School of Medicine, Roanoke, VA, USA.
Carilion Roanoke Memorial Hospital, Roanoke, VA, USA.
Appl Nurs Res. 2016 May;30:12-5. doi: 10.1016/j.apnr.2015.08.006. Epub 2015 Aug 20.
End-of-life (EOL) conversations are difficult for patients, families, and nurses. The purpose of this article is to describe the challenges encountered and strategies implemented during a research study designed to elicit information about the congruence among patients' stated preferences at EOL with perceptions of their caregivers and nurses using the Preferences About Dying and Death (PADD) instrument in an acute care setting. With the proper study inclusion criteria, education and support from more confident, experienced colleagues, nurses can be coached to identify appropriate participants for EOL research. Researchers should plan regularly scheduled debriefing sessions with interviewers to provide emotional support and encouragement to minimize distress. A scripted approach to introduce EOL research topics can ease clinicians' discomfort while allowing patients the opportunity to have open, honest dialogues about their care preferences. By proactively implementing strategies, researchers can enhance the integration of EOL research into the acute care setting.
临终(EOL)对话对于患者、家属和护士来说都很困难。本文旨在描述在一项研究中遇到的挑战以及实施的策略,该研究旨在通过使用急性护理环境中的死亡与临终偏好(PADD)工具,获取有关患者临终时陈述的偏好与他们的护理人员和护士认知之间一致性的信息。通过适当的研究纳入标准,以及来自更自信、经验更丰富的同事的教育和支持,护士可以得到指导,以识别适合临终研究的参与者。研究人员应定期与访谈者安排汇报会议,提供情感支持和鼓励,以尽量减少困扰。采用脚本化方法引入临终研究主题可以减轻临床医生的不适感,同时让患者有机会就他们的护理偏好进行开放、坦诚的对话。通过积极实施策略,研究人员可以加强临终研究在急性护理环境中的整合。