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加拿大肿瘤学家在处理患者艰难死亡情况时的经历及所采用的应对策略。

Experiences of Canadian oncologists with difficult patient deaths and coping strategies used.

作者信息

Granek L, Barbera L, Nakash O, Cohen M, Krzyzanowska M K

机构信息

Department of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Department of Radiation Oncology, University of Toronto, Toronto, ON.

出版信息

Curr Oncol. 2017 Aug;24(4):e277-e284. doi: 10.3747/co.24.3527. Epub 2017 Aug 31.

Abstract

OBJECTIVES

We aimed to explore and identify what makes patient death more emotionally difficult for oncologists and how oncologists cope with patient death.

METHODS

A convenience sample of 98 Canadian oncologists (50 men, 48 women) completed an online survey that included a demographics section and a section about patient death.

RESULTS

More than 80% of oncologists reported that patient age, long-term management of a patient, and unexpected disease outcomes contributed to difficult patient loss. Other factors included the doctor-patient relationship, identification with the patient, caregiver-related factors, oncologist-related factors, and "bad deaths." Oncologists reported varying strategies to cope with patient death. Most prevalent was peer support from colleagues, including nurses and other oncologists. Additional strategies included social support, exercise and meditation, faith, vacations, and use of alcohol and medications.

CONCLUSIONS

Oncologists listed a number of interpersonal and structural factors that make patient death challenging for them to cope with. Oncologists reported a number of coping strategies in responding to patient death, including peer support, particularly from nursing colleagues. No single intervention will be suitable for all oncologists, and institutions wishing to help their staff cope with the emotional difficulty of patient loss should offer a variety of interventions to maximize the likelihood of oncologist participation.

摘要

目的

我们旨在探索并确定是什么让患者死亡对肿瘤学家而言在情感上更难以承受,以及肿瘤学家如何应对患者死亡。

方法

选取98名加拿大肿瘤学家(50名男性,48名女性)作为便利样本,他们完成了一项在线调查,该调查包括一个人口统计学部分和一个关于患者死亡的部分。

结果

超过80%的肿瘤学家报告称,患者年龄、对患者的长期管理以及意外的疾病结局导致了难以承受的患者离世。其他因素包括医患关系、对患者的认同、护理人员相关因素、肿瘤学家相关因素以及“不良死亡”。肿瘤学家报告了应对患者死亡的不同策略。最普遍的是来自同事的同伴支持,包括护士和其他肿瘤学家。其他策略包括社会支持、锻炼和冥想、信仰、休假以及使用酒精和药物。

结论

肿瘤学家列出了一些人际和结构因素,这些因素使得患者死亡对他们来说难以应对。肿瘤学家报告了应对患者死亡的一些策略,包括同伴支持,尤其是来自护理同事的支持。没有一种单一的干预措施适用于所有肿瘤学家,希望帮助其员工应对患者离世所带来情感困扰的机构应该提供多种干预措施,以最大限度地提高肿瘤学家参与的可能性。

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