Wäscher Sebastian, Salloch Sabine, Ritter Peter, Vollmann Jochen, Schildmann Jan
Bioethics. 2017 May;31(4):237-245. doi: 10.1111/bioe.12347.
This article describes a process of developing, implementing and evaluating a clinical ethics support service intervention with the goal of building up a context-sensitive structure of minimal clinical-ethics in an oncology department without prior clinical ethics structure. Scholars from different disciplines have called for an improvement in the evaluation of clinical ethics support services (CESS) for different reasons over several decades. However, while a lot has been said about the concepts and methodological challenges of evaluating CESS up to the present time, relatively few empirical studies have been carried out. The aim of this article is twofold. On the one hand, it describes a process of development, modifying and evaluating a CESS intervention as part of the ETHICO research project, using the approach of qualitative-formative evaluation. On the other hand, it provides a methodological analysis which specifies the contribution of qualitative empirical methods to the (formative) evaluation of CESS. We conclude with a consideration of the strengths and limitations of qualitative evaluation research with regards to the evaluation and development of context sensitive CESS. We further discuss our own approach in contrast to rather traditional consult or committee models.
本文描述了一个开发、实施和评估临床伦理支持服务干预措施的过程，其目标是在一个没有先前临床伦理结构的肿瘤科室中建立一个因地制宜的最低限度临床伦理结构。几十年来，来自不同学科的学者出于不同原因呼吁改进对临床伦理支持服务（CESS）的评估。然而，尽管到目前为止，关于评估CESS的概念和方法挑战已经谈了很多，但相对较少有实证研究。本文的目的有两个。一方面，它描述了作为ETHICO研究项目一部分，使用定性形成性评估方法来开发、修改和评估CESS干预措施的过程。另一方面，它提供了一种方法分析，明确了定性实证方法对CESS（形成性）评估的贡献。我们最后考虑了定性评估研究在评估和开发因地制宜的CESS方面的优势和局限性。我们还将我们自己的方法与相当传统的咨询或委员会模式进行了对比讨论。
