支持印度护士并改善肿瘤学与姑息治疗服务的建议。
Recommendations to Support Nurses and Improve the Delivery of Oncology and Palliative Care in India.
作者信息
LeBaron Virginia T, Palat Gayatri, Sinha Sudha, Chinta Sanjeeva Kumari, Jamima Beaulah John Battula, Pilla Usha Lakshmi, Podduturi Nireekshana, Shapuram Yadamma, Vennela Padma, Rapelli Vineela, Lalani Zahra, Beck Susan L
机构信息
Department of Acute and Specialty Care, University of Virginia School of Nursing, Charlottesville, VA, USA.
Palliative Access Programme, Two Worlds Cancer Collaboration-INCTR, Canada.
出版信息
Indian J Palliat Care. 2017 Apr-Jun;23(2):188-198. doi: 10.4103/IJPC.IJPC_153_16.
CONTEXT
Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training.
AIM
The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care.
METHODS
Qualitative ethnography.
SETTING
The study was conducted at a government cancer hospital in urban South India.
SAMPLE
Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members) who interact closely with nurses were included in the study.
DATA COLLECTION
Data were collected over 9 months (September 2011- June 2012). Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews.
ANALYSIS
Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns.
RESULTS
Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training.
CONCLUSIONS
Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing practice.
背景
印度的护士通常在资源有限的环境中工作，照顾症状负担较重的癌症患者，但接受的肿瘤学或姑息治疗培训很少。
目的
本研究的目的是探讨印度护士所面临的挑战，并提出改善肿瘤学和姑息治疗服务的建议。
方法
定性人种志研究。
地点
研究在印度南部城市的一家政府癌症医院进行。
样本
37名肿瘤学/姑息治疗护士以及22名与护士密切互动的其他人员（医生、社会工作者、药剂师、患者/家庭成员）纳入研究。
数据收集
数据收集历时9个月（2011年9月至2012年6月）。主要数据来源包括400多个小时的参与观察和54次录音半结构化访谈。
分析
对实地记录和访谈转录本进行系统的定性分析，确定关键主题和模式。
结果
护士的主要担忧包括化疗给药的安全性、工作量和文书工作责任、病房内死亡的患者、对家属的监护以及物资短缺。许多参与者表示苦恼，因为他们没有接受过正规的肿瘤学培训。
结论
支持印度护士的建议包括：优先考虑安全，优化护士角色并探索创新的护理模式，赋予护士权力，加强护士领导力，提供相关教育项目，加强团队合作，改善癌症疼痛管理，开展研究和质量改进项目。实施支持护士的干预措施需要强大的机构承诺和领导力。成功的干预措施必须考虑现有的文化和专业规范，并首先满足护士的安全需求。现有护理模式的积极方面可以进行调整并融入一般护理实践。
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