South Dakota State University College of Nursing, Brookings, SD, USA.
South Dakota State University College of Nursing, Sioux Falls, SD, USA.
J Clin Nurs. 2018 Jan;27(1-2):173-181. doi: 10.1111/jocn.13867. Epub 2017 Jun 27.
To describe rural and urban palliative/hospice care nurses' communication strategies while providing spiritual care for patients and families at end of life.
Nurses aim to provide holistic care consisting of physical, psychological and spiritual components. However, it is well documented that spiritual care is largely missing from nursing care. Internationally, spiritual care is a growing topic of interest, yet many nurses feel unprepared to deliver spiritual care.
This qualitative study used Braun and Clarke's thematic analysis method.
As part of a larger multimethod study, this study shares the narrative descriptions from 10 experienced palliative/hospice care nurses. Individual, face-to-face interviews were conducted and lasted 45-60 minutes. Each interview started with the same lead-in questions, was audio-recorded and was transcribed verbatim. The research team used an inductive analysis approach and met several times reviewing and analysing the detected themes until reaching consensus.
The primary theme, sentience includes the capacity to act, a willingness to enter into the unknown and the ability to have deep meaningful conversations with patients regardless of the path it may yield. Subthemes include: (i) Willingness to Go There, (ii) Being in "A" Moment and (iii) Sagacious Insight.
Nurses are integral in the provision of spiritual care for patients/families across the lifespan and at end of life. Nurses must feel confident and competent before they are willing to enter uncomfortable spaces with patients/families. Nursing curriculum must include purposeful engagement and focused debriefing in spiritual assessment and care.
There is a dire need to prepare undergraduate and graduate students to assess and support a patient's spiritual needs. Addressing spiritual care content as a clinical and educational priority will promote a patient-centred approach for spiritual care and can further shape nursing curricula, policies, guidelines and assessment tools.
描述农村和城市姑息/临终关怀护士在为临终患者和家属提供精神关怀时的沟通策略。
护士的目标是提供包括身体、心理和精神成分在内的整体护理。然而,有大量文献记录表明,精神护理在护理中基本上是缺失的。在国际上,精神护理是一个日益受到关注的话题,但许多护士觉得自己没有准备好提供精神护理。
本 qualitative 研究采用了 Braun 和 Clarke 的主题分析方法。
作为一项更大的多方法研究的一部分,本研究分享了 10 名经验丰富的姑息/临终关怀护士的叙述描述。进行了单独的面对面访谈,持续 45-60 分钟。每次访谈都以相同的引导问题开始,进行录音,并逐字记录。研究团队采用了归纳分析方法,并多次开会审查和分析所发现的主题,直到达成共识。
主要主题是感知能力,包括行动能力、愿意进入未知领域的意愿以及能够与患者进行深刻而有意义的对话的能力,无论可能产生的结果如何。子主题包括:(i)愿意去那里,(ii)处于“A”时刻,(iii)明智的洞察力。
护士在提供患者/家属的精神护理方面发挥着重要作用,贯穿整个生命周期和临终阶段。护士在愿意与患者/家属进入不舒服的空间之前,必须感到自信和有能力。护理课程必须包括在精神评估和护理方面有目的的参与和集中的汇报。
迫切需要为本科和研究生学生准备评估和支持患者精神需求的课程。将精神护理内容作为临床和教育重点,将促进以患者为中心的精神护理方法,并进一步塑造护理课程、政策、指南和评估工具。