Warnock Clare, Buchanan Jean, Tod Angela Mary
Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
School of Nursing and Midwifery, The University of Sheffield, UK.
J Adv Nurs. 2017 Jul;73(7):1632-1645. doi: 10.1111/jan.13252. Epub 2017 Feb 14.
The aim of this study was to explore the difficulties experienced by nurses and healthcare professionals when engaging in the process of breaking bad news.
The challenges faced by staff when breaking bad news have previously been researched in relation to particular settings or participants. This study involved staff from diverse settings and roles to develop broader insights into the range of difficulties experienced in clinical practice.
The study used a descriptive survey design involving self-reported written accounts and framework analysis.
Data were collected using a structured questionnaire containing a free text section that asked participants to describe a difficult experience they had encountered when involved in the process of breaking bad news. Data were collected from healthcare staff from hospital, community, hospice and care home settings attending training days on breaking bad news between April 2011 and April 2014.
Multiple inter-related factors presented challenges to staff engaging in activities associated with breaking bad news. Traditional subjects such as diagnostic and treatment information were described but additional topics were identified such as the impact of illness and care at the end of life. A descriptive framework was developed that summarizes the factors that contribute to creating difficult experiences for staff when breaking bad news.
The framework provides insights into the scope of the challenges faced by staff when they engage in the process of breaking bad news. This provides the foundation for developing interventions to support staff that more closely matches their experiences in clinical practice.
本研究旨在探讨护士和医疗保健专业人员在传递坏消息过程中所经历的困难。
此前已针对特定环境或参与者对工作人员在传递坏消息时所面临的挑战进行了研究。本研究涉及来自不同环境和角色的工作人员，以更全面地了解临床实践中所经历的各种困难。
本研究采用描述性调查设计，包括自我报告的书面记录和框架分析。
使用结构化问卷收集数据，问卷包含一个自由文本部分，要求参与者描述他们在参与传递坏消息过程中遇到的一次困难经历。数据收集自2011年4月至2014年4月期间参加坏消息传递培训日的医院、社区、临终关怀机构和养老院的医护人员。
多个相互关联的因素给参与与传递坏消息相关活动的工作人员带来了挑战。研究描述了诸如诊断和治疗信息等传统主题，但也确定了其他主题，如疾病的影响和临终护理。开发了一个描述性框架，总结了在传递坏消息时给工作人员带来困难经历的因素。
该框架深入了解了工作人员在传递坏消息过程中所面临挑战的范围。这为制定更符合他们临床实践经验的支持工作人员的干预措施奠定了基础。
