General Practice - Center of Expertise Palliative Care Utrecht, Julius Center for Healthcare Sciences and Primary Care / Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
General Practice -Center of Expertise Palliative Care Utrecht, Julius Center for Healthcare Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
BMJ Support Palliat Care. 2020 Jun;10(2):e15. doi: 10.1136/bmjspcare-2016-001187. Epub 2017 Jun 30.
To provide insight into what nurses know, do and need to provide support to anxious patients in hospice care (HC).
A mixed method study consisted of an online survey and focus groups (FGs) about what nurses know, do, and need was conducted. 336 HC nurses were invited to participate. Descriptive statistics were computed using SPSS. The χ and t-tests were conducted to compare. The FGs were transcribed verbatim and thematically analysed.
The survey was completed by 265 nurses (79%), and five FGs (n=25) were conducted. Most nurses had >10 years working experience; mean age was 52. The majority (59%) felt that they were equipped with sufficient knowledge; however, lack of knowledge (31%) as well as lack of time (50%) were hampering factors. Identification of anxiety was difficult due to the variety of its expression. Tools for identifying were used by 37%. Interventions were generally chosen intuitively. A major responsibility was experienced in caring for patients with panic attacks during late night shifts, making immediate decisions necessary.
This study highlights the struggles of nurses caring for anxious patients in HC. Anxiety management is dependent on the competencies and preferences of the individual nurse. One-third of the nurses require additional training. According to HC nurses, the intervention set should include guidelines for applying assessment tools, effective communication strategies and decision models as well as prediction models in order to select tailored interventions. Future research should focus on patients' perspectives in order to understand crucial measures for anxiety management.
深入了解护士在临终关怀(HC)中为焦虑患者提供支持所具备的知识、采取的措施和需求。
本研究采用混合方法,包括在线调查和焦点小组(FG),以了解护士所具备的知识、采取的措施和需求。共邀请 336 名 HC 护士参与。使用 SPSS 计算描述性统计数据。采用 χ 和 t 检验进行比较。FG 的转录内容进行了主题分析。
调查由 265 名护士(79%)完成,进行了 5 个 FG(n=25)。大多数护士有超过 10 年的工作经验;平均年龄为 52 岁。大多数护士(59%)认为他们具备充足的知识,但缺乏知识(31%)和缺乏时间(50%)是阻碍因素。由于焦虑的表现形式多样,识别起来较为困难。只有 37%的护士使用了识别工具。干预措施通常是凭直觉选择的。护士在夜间值班时需要照顾患有惊恐发作的患者,这一重大责任导致他们需要立即做出决策。
本研究强调了护士在 HC 中照顾焦虑患者所面临的困难。焦虑管理取决于护士个人的能力和偏好。三分之一的护士需要额外的培训。根据 HC 护士的意见,干预措施应包括评估工具应用指南、有效的沟通策略和决策模型以及预测模型,以便选择量身定制的干预措施。未来的研究应关注患者的观点,以了解焦虑管理的关键措施。