Henderson Amanda, Young Jeanine, Herbert Anthony, Bradford Natalie, Pedersen Lee-Anne
1 School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast , Sippy Downs, Australia .
2 Lady Cilento Children's Hospital, Children's Health Queensland Hospital and Health Service , South Brisbane, Australia .
J Palliat Med. 2017 Jun;20(6):662-666. doi: 10.1089/jpm.2016.0367. Epub 2017 Feb 10.
Preparedness to initiate end-of-life (EoL) discussions is a confronting and daunting task for all healthcare professionals. We conducted a group interview to explore healthcare professionals' experiences of preparing for EoL discussions with the patient and their family in a pediatric context.
To identify what pediatric healthcare professionals consider important when preparing for an EoL discussion.
A qualitative design using a group interview. Two open-ended questions were asked: (1) How could preparedness to initiate EoL care discussions between healthcare professionals and the patient and family be enhanced? (2) What education resources/strategies could be developed to support preparation for EoL care discussions?
SETTING/SUBJECTS: Healthcare professionals, including medical, nursing, and allied health professionals working in pediatric palliative care settings across Queensland, Australia. These settings included major tertiary hospitals, general practice, community, and nongovernment organizations. A convenience sample of 36 healthcare professionals consented to participate in the study.
An analysis of the data identified seven themes that had relevance for preparing for an EoL discussion: communication, healthcare professional perspectives, interdisciplinary team role, patient and family perspectives, practical issues, addressing mistakes, and healthcare professional education.
Pediatric healthcare professionals confirmed that gaps exist in preparing for an EoL discussion. The findings support a need for further research in two areas. First, a systematic review of interdisciplinary resources that are available to support healthcare professionals in preparing for EoL discussions is recommended. Second, evidence-based interdisciplinary interventions to support pediatric EoL discussions need to be developed and evaluated.
对于所有医疗保健专业人员而言，准备开展临终讨论都是一项令人为难且艰巨的任务。我们进行了一次小组访谈，以探讨医疗保健专业人员在儿科环境中为与患者及其家属进行临终讨论做准备的经历。
确定儿科医疗保健专业人员在为临终讨论做准备时认为重要的因素。
采用小组访谈的定性设计。提出了两个开放式问题：（1）如何加强医疗保健专业人员与患者及其家属之间开展临终护理讨论的准备工作？（2）可以开发哪些教育资源/策略来支持临终护理讨论的准备工作？
背景/对象：医疗保健专业人员，包括在澳大利亚昆士兰州儿科姑息治疗环境中工作的医学、护理和专职医疗专业人员。这些环境包括大型三级医院、全科医疗、社区和非政府组织。36名医疗保健专业人员的便利样本同意参与该研究。
对数据的分析确定了与准备临终讨论相关的七个主题：沟通、医疗保健专业人员的观点、跨学科团队的作用、患者及其家属的观点、实际问题、应对失误和医疗保健专业人员教育。
儿科医疗保健专业人员证实，在准备临终讨论方面存在差距。研究结果支持在两个领域进行进一步研究。第一，建议对可用于支持医疗保健专业人员准备临终讨论的跨学科资源进行系统综述。第二，需要开发和评估支持儿科临终讨论的循证跨学科干预措施。
