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“临终时刻可能发生在任何病房”:一项针对医院志愿者临终关怀培训需求和学习偏好的定性研究。

'End of life could be on any ward really': A qualitative study of hospital volunteers' end-of-life care training needs and learning preferences.

机构信息

1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy, and Rehabilitation, London, UK.

2 Guy's and St Thomas' NHS Foundation Trust, London, UK.

出版信息

Palliat Med. 2017 Oct;31(9):842-852. doi: 10.1177/0269216316679929. Epub 2017 Jan 6.

Abstract

BACKGROUND

Over half of all deaths in Europe occur in hospital, a location associated with many complaints. Initiatives to improve inpatient end-of-life care are therefore a priority. In England, over 78,000 volunteers provide a potentially cost-effective resource to hospitals. Many work with people who are dying and their families, yet little is known about their training in end-of-life care.

AIMS

To explore hospital volunteers' end-of-life care training needs and learning preferences, and the acceptability of training evaluation methods.

DESIGN

Qualitative focus groups.

SETTING/PARTICIPANTS: Volunteers from a large teaching hospital were purposively sampled.

RESULTS

Five focus groups were conducted with 25 hospital volunteers (aged 19-80 years). Four themes emerged as follows: preparation for the volunteering role, training needs, training preferences and evaluation preferences. Many described encounters with patients with life-threatening illness and their families. Perceived training needs in end-of-life care included communication skills, grief and bereavement, spiritual diversity, common symptoms, and self-care. Volunteers valued learning from peers and end-of-life care specialists using interactive teaching methods including real-case examples and role plays. A chance to 'refresh' training at a later date was suggested to enhance learning. Evaluation through self-reports or observations were acceptable, but ratings by patients, families and staff were thought to be pragmatically unsuitable owing to sporadic contact with each.

CONCLUSION

Gaps in end-of-life care training for hospital volunteers indicate scope to maximise on this resource. This evidence will inform development of training and evaluations which could better enable volunteers to make positive, cost-effective contributions to end-of-life care in hospitals.

摘要

背景

欧洲超过一半的死亡发生在医院,医院是一个存在诸多投诉的地方。因此,改善住院患者临终关怀的举措是当务之急。在英国,超过 78000 名志愿者为医院提供了一种具有潜在成本效益的资源。许多志愿者与临终患者及其家属一起工作,但对他们在临终关怀方面的培训知之甚少。

目的

探讨医院志愿者的临终关怀培训需求和学习偏好,以及培训评估方法的可接受性。

设计

定性焦点小组。

地点/参与者:从一家大型教学医院有目的地抽取志愿者。

结果

对 25 名医院志愿者(年龄 19-80 岁)进行了 5 次焦点小组讨论。出现了以下 4 个主题:为志愿者角色做准备、培训需求、培训偏好和评估偏好。许多人描述了与患有危及生命的疾病的患者及其家人的接触。临终关怀培训需求包括沟通技巧、悲伤和丧亲之痛、精神多样性、常见症状和自我护理。志愿者们重视从同行和临终关怀专家那里学习,使用互动教学方法,包括真实案例和角色扮演。建议提供一个“刷新”培训的机会,以提高学习效果。通过自我报告或观察进行评估是可以接受的,但由于与每位患者、家属和工作人员的接触是零星的,因此认为通过患者、家属和工作人员的评分在实践上是不合适的。

结论

医院志愿者临终关怀培训方面的差距表明,有必要充分利用这一资源。这一证据将为培训和评估的发展提供信息,这将使志愿者能够更好地为医院的临终关怀做出积极的、具有成本效益的贡献。

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