Jors Karin, Tietgen Svenja, Xander Carola, Momm Felix, Becker Gerhild
1 Clinic for Palliative Care, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
2 Department of Radio-oncology, St. Josefsklinik Offenburg, Offenburg, Germany.
Palliat Med. 2017 Jan;31(1):63-71. doi: 10.1177/0269216316648071. Epub 2016 Jul 10.
BACKGROUND/AIM: Palliative care is based on multi-professional team work. In this study, we investigated how cleaning staff communicate and interact with seriously ill and dying patients as well as how cleaning staff cope with the situation of death and dying.
Sequential mixed methods, consisting of semi-structured interviews, focus groups, and a questionnaire. Interviews and focus group discussions were content analyzed and results were used to create a questionnaire. Quantitative data were submitted to descriptive analysis.
Large university clinic in southern Germany.
A total of 10 cleaning staff participated in the interviews and 6 cleaning staff took part in the focus group discussion. In addition, three managerial cleaning staff participated in a separate focus group. Questionnaires were given to all cleaning staff ( n = 240) working at the clinic in September 2008, and response rate was 52% (125/240).
Cleaning staff described interactions with patients as an important and fulfilling aspect of their work. About half of participants indicated that patients talk with them every day, on average for 1-3 min. Conversations often revolved around casual topics such as weather and family, but patients also discussed their illness and, occasionally, thoughts regarding death with cleaning staff. When patients addressed illness and death, cleaning staff often felt uncomfortable and helpless.
Cleaning staff perceive that they have an important role in the clinic-not only cleaning but also supporting patients. Likewise, patients appreciate being able to speak openly with cleaning staff. Still, it appears that cleaning staff may benefit from additional training in communication about sensitive issues such as illness and death.
背景/目的：姑息治疗基于多专业团队协作。在本研究中，我们调查了清洁人员如何与重症和临终患者进行沟通与互动，以及他们如何应对死亡和临终情境。
序贯混合方法，包括半结构式访谈、焦点小组讨论和问卷调查。对访谈和焦点小组讨论进行内容分析，并将结果用于编制问卷。对定量数据进行描述性分析。
德国南部的大型大学诊所。
共有10名清洁人员参与了访谈，6名清洁人员参加了焦点小组讨论。此外，三名管理清洁人员参加了一个单独的焦点小组。2008年9月，向诊所所有清洁人员（n = 240）发放了问卷，回复率为52%（125/240）。
清洁人员将与患者的互动描述为工作中重要且有意义的方面。约一半的参与者表示患者每天与他们交谈，平均交谈1 - 3分钟。谈话内容通常围绕天气和家庭等日常话题，但患者也会与清洁人员讨论自己的病情，偶尔还会提及关于死亡的想法。当患者谈到病情和死亡时，清洁人员常常感到不安和无助。
清洁人员认为他们在诊所中不仅有清洁的重要作用，还有支持患者的作用。同样，患者也感激能够与清洁人员坦诚交谈。不过，清洁人员似乎可能会从关于疾病和死亡等敏感问题沟通的额外培训中受益。
