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对医疗保健专业人员在急性护理环境中对精神困扰管理的理解与方法的定性分析。

A Qualitative Analysis of a Healthcare Professional's Understanding and Approach to Management of Spiritual Distress in an Acute Care Setting.

作者信息

Selby Debbie, Seccaraccia Dori, Huth Jim, Kurrpa Kristin, Fitch Margaret

机构信息

1 Sunnybrook Health Sciences Center , Toronto, Ontario, Canada .

2 Faculty of Nursing, University of Toronto , Toronto, Ontario, Canada .

出版信息

J Palliat Med. 2016 Nov;19(11):1197-1204. doi: 10.1089/jpm.2016.0135. Epub 2016 Oct 18.

Abstract

OBJECTIVE

The goal of this study was to explore healthcare professionals' (HCPs') perception of their role in provision of spiritual care, in addition to attempting to identify a simple question(s) to help identify spiritual distress.

BACKGROUND

Spirituality is well recognized as important to whole-person care, particularly in those with terminal illnesses. Understanding the role of front-line providers in the identification and management of spiritual distress, however, remains challenging.

METHODS

Twenty-one HCPs (eight physicians, seven nurses, six social workers) underwent qualitative semi-structured interviews exploring an understanding of spirituality/spiritual distress. HCPs were drawn from inpatient and outpatient settings in a tertiary care facility, and all had experience with patients with terminal illnesses. Interviews were subsequently coded and analyzed for dominant themes.

RESULTS

Essentially all participants spoke of the high importance of spirituality and spiritual care, particularly for those facing end of life. However, the majority of HCPs had difficulty in formulating definitions/descriptions of spiritual care and spiritual distress, in marked contradistinction to the importance they ascribed to this aspect of holistic care. Almost universally provision of spiritual care was seen as critical, yet in the domain of chaplaincy/dedicated spiritual care providers. Reasons frequently cited for HCP's reluctance to provide such care themselves included time available, lack of training and expertise, and the sense that others could do a better job.

DISCUSSION

Despite spirituality being highlighted as important to care, few HCPs felt able to provide this, raising questions around how such care can be encouraged and developed in busy acute care settings.

摘要

目的

本研究的目的是探讨医疗保健专业人员(HCPs)对其在提供精神关怀方面作用的看法,此外还试图确定一个简单的问题来帮助识别精神困扰。

背景

精神层面对于全人护理的重要性已得到广泛认可,尤其是在患有绝症的患者中。然而,了解一线医护人员在识别和管理精神困扰方面的作用仍然具有挑战性。

方法

21名医疗保健专业人员(8名医生、7名护士、6名社会工作者)接受了定性半结构化访谈,以探讨对精神层面/精神困扰的理解。这些医疗保健专业人员来自一家三级医疗机构的住院部和门诊部,并且都有照顾绝症患者的经验。随后对访谈进行编码并分析主导主题。

结果

基本上所有参与者都谈到了精神层面和精神关怀的高度重要性,特别是对于那些面临生命终结的人。然而,大多数医疗保健专业人员难以对精神关怀和精神困扰进行定义/描述,这与他们赋予整体护理这一方面的重要性形成明显反差。几乎所有人都认为提供精神关怀至关重要,但这被视为是牧师/专门的精神关怀提供者的领域。医疗保健专业人员自己不愿提供此类关怀的常见原因包括可用时间、缺乏培训和专业知识,以及感觉其他人能做得更好。

讨论

尽管精神层面被强调对护理很重要,但很少有医疗保健专业人员觉得自己能够提供这种关怀,这引发了关于如何在繁忙的急症护理环境中鼓励和发展此类关怀的问题。

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