Stayer Debbie, Lockhart Joan Such
Debbie Stayer is an assistant professor, Department of Nursing, Bloomsburg University of Pennsylvania, Bloomsburg, Pennsylvania. Joan Such Lockhart is a professor, Duquesne University School of Nursing, Pittsburgh, Pennsylvania.
Am J Crit Care. 2016 Jul;25(4):350-6. doi: 10.4037/ajcc2016251.
Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units.
To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children's families.
A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences.
Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child's death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support.
Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children's families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying.
尽管有报道称，为儿童提供姑息治疗的护士面临诸多挑战，但很少有研究从儿科重症监护病房中照顾患有危及生命疾病儿童的护士的角度来审视这一现象。
描述并解读儿科重症监护病房中为患有危及生命疾病的儿童及其家庭提供姑息治疗的护士的经历本质。
在美国东北部对12名儿科重症监护病房护士进行了诠释现象学研究。通过面对面访谈和实地记录来阐明这些经历。
发现了五个主要主题：走向死亡的旅程；终身负担；以及在提供护理、维持自我和跨越界限方面的挑战。这些主题由12个子主题阐明：垂死儿童的情感影响、儿童死亡的情感影响、同时悲痛、创造平静的结局、父母的护理负担、为家庭维持希望、疼痛、医生沟通不清晰、需要倾听儿童的声音、尊重父母的意愿、同事间的情谊和支持以及个人支持。
为患有危及生命疾病的儿童提供姑息治疗对护士来说很复杂。研究结果揭示了在照顾垂死儿童及其家庭时有时会遇到具有挑战性的复杂情况。然而，护士们表示在提供姑息治疗以及得到同事支持方面有职业满足感。尽管护士们提到了同事间的情谊，但仍需要进一步研究以确定可能有助于工作人员处理和应对死亡及临终问题的其他支持资源。
