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“就像抓住我的心脏并挤压它一样”:描述并解释儿科肿瘤环境中接收坏消息时的情绪体验。

'Just gripping my heart and squeezing': Naming and explaining the emotional experience of receiving bad news in the paediatric oncology setting.

机构信息

School of Health in Social Science, The University of Edinburgh, Medical School, Teviot Place, Edinburgh, EH8 9AG, United Kingdom.

School of Healthcare Sciences, Cardiff University, Heath Park Campus, Cardiff, CF14 4XN, United Kingdom.

出版信息

Patient Educ Couns. 2017 Sep;100(9):1751-1757. doi: 10.1016/j.pec.2017.03.028. Epub 2017 Apr 2.

Abstract

OBJECTIVE

To explore recipients' perspectives on the range and origins of their emotional experiences during their 'bad news' consultations.

METHODS

Participants were four bereaved families of children who had changed from active treatment to palliative care in paediatric oncology. Data was collected using emotional touchpoint storytelling. The names (descriptors) given to the emotional experiences were linguistically classified. Explanations of their perceived origins were examined using applied thematic analysis.

RESULTS

26 descriptors were given, relating to bodily sensations, affective states, evaluations and cognitive conditions. Three themes were identified in the origins of these experiences - 'becoming aware', 'the changes' and 'being in this situation'. Parents described strong emotional displays during the consultation including physical collapse. These related to the internal process of 'becoming aware'. Three descriptors were given as originating from the clinicians and their delivery of the news - 'supported', 'included', 'trusting'.

CONCLUSIONS

Recipients perceive their emotional experiences as mainly originating from the news itself, and perceived consequences of it, rather than its delivery. Strong emotional reactions during the interaction are not necessarily an indicator of ineffectual delivery.

PRACTICE IMPLICATIONS

Findings offer a thematic framing that may support and deepen practitioners understanding of recipients' emotional reactions during bad news consultations.

摘要

目的

探讨接受者在接受“坏消息”咨询时对其情绪体验范围和来源的看法。

方法

参与者为 4 名在儿科肿瘤学中从积极治疗转为姑息治疗的儿童丧亲家庭。使用情感触点叙事法收集数据。对情感体验赋予的名称(描述符)进行了语言学分类。使用应用主题分析检查了其感知起源的解释。

结果

共给出了 26 个描述符,涉及身体感觉、情感状态、评估和认知状况。这些体验的起源有三个主题——“意识到”、“变化”和“处于这种情况”。父母在咨询中描述了强烈的情绪表现,包括身体崩溃。这些与“意识到”的内部过程有关。有三个描述符来自临床医生及其传递的消息——“支持”、“包括”、“信任”。

结论

接受者认为他们的情绪体验主要源自消息本身及其后果,而不是消息的传递。在互动过程中强烈的情绪反应不一定是无效传递的指标。

实践意义

研究结果提供了一个主题框架,可能支持并加深从业者对接受者在坏消息咨询中情绪反应的理解。

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