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在存在主义危机中提供支持:姑息治疗培训模式的混合方法评估。

Supporting in an existential crisis: A mixed-methods evaluation of a training model in palliative care.

机构信息

Department of Oncology-Pathology,Karolinska Institutet and Stockholms Sjukhems foundation R&D,Stockholm,Sweden.

Department of Neurobiology,Care Sciences and Society,Karolinska Institutet and Stockholms Sjukhems Foundation R&D,Stockholm,Sweden.

出版信息

Palliat Support Care. 2018 Aug;16(4):470-478. doi: 10.1017/S1478951517000633. Epub 2017 Jun 20.

Abstract

BACKGROUND

Palliative care staff often report that they lack the skills and confidence to provide support during an existential crisis. Consequently, there is a definite need for a training program in this area.

OBJECTIVE

Our aim was to investigate whether a training model could give palliative care staff increased knowledge, awareness, and preparedness-all useful tools for providing support.

METHODS

A mixed-methods research design was used. Data were collected in four hospital-based palliative homecare teams in the Stockholm area. In total, 34 staff participated, representing different palliative care team professions. Before and after the intervention, a questionnaire with a 9-point Likert-type scale was completed (n = 34). Qualitative focus group discussions were conducted a month after the intervention (25 participants). These were recorded, transcribed, and analyzed using qualitative content analysis with a manifest focus.

RESULTS

In the quantitative part of our study, the participants showed significantly increased perceived knowledge, awareness, and preparedness in every aspect (p < 0.001 for all items). The focus group discussions revealed a process that made it possible to apply new knowledge and insight. The process began with theoretical knowledge and, through care-related reflection and self-reflection, the knowledge base gradually developed and provided useful skills and increased job satisfaction.

SIGNIFICANCE OF RESULTS

The team-based "TrainingModel Sand/TER" can be performed without excessive effort and contribute to improved competence in providing support during an existential crisis. It is particularly useful for staff working in clinical palliative care.

摘要

背景

姑息治疗工作人员经常报告说,他们缺乏在存在危机期间提供支持的技能和信心。因此,在这方面确实需要一个培训计划。

目的

我们的目的是调查培训模式是否可以提高姑息治疗工作人员的知识、意识和准备度,这些都是提供支持的有用工具。

方法

采用混合方法研究设计。数据收集于斯德哥尔摩地区的四个基于医院的姑息家庭护理团队中。共有 34 名工作人员参与,代表不同的姑息治疗团队专业。在干预前后,用 9 分李克特量表完成了一份问卷(n = 34)。干预后一个月进行了定性焦点小组讨论(25 名参与者)。这些讨论被记录、转录,并使用具有明显重点的定性内容分析进行分析。

结果

在我们研究的定量部分,参与者在各个方面的感知知识、意识和准备度都显著提高(所有项目的 p < 0.001)。焦点小组讨论揭示了一个应用新知识和洞察力的过程。该过程始于理论知识,通过与护理相关的反思和自我反思,知识基础逐渐发展,提供了有用的技能并提高了工作满意度。

结果的意义

基于团队的“培训模型和/或 TER”可以在不付出过多努力的情况下进行,并有助于提高在存在危机期间提供支持的能力。它对在临床姑息治疗中工作的工作人员特别有用。

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