在引领和跟随患者及家属之间寻求平衡——护士在从延长生命的治疗向姑息治疗过渡中促进这一转变的策略：一项访谈研究。
Striving for a balance between leading and following the patient and family - nurses' strategies to facilitate the transition from life-prolonging care to palliative care: an interview study.
机构信息
Örebro University Hospital, Örebro, Sweden.
Clinical Skills Centre, Örebro University Hospital, Örebro, Sweden.
出版信息
BMC Palliat Care. 2018 Apr 3;17(1):55. doi: 10.1186/s12904-018-0311-7.
BACKGROUND
The transition from life-prolonging to palliative care (PC) can be challenging often characterized by psychical, physiological, social and existential changes. Knowledge of how to support the patient and family in this specific care phase is lacking, and this area needs to be further explored. The aim of this study was to investigate strategies that registered nurses (RNs) use to ease the transition from life-prolonging care to PC for patients with incurable disease.
METHODS
The study has a descriptive design. Fourteen RNs working in a specialized PC unit were interviewed. The data were analysed using content analysis.
RESULTS
The RNs' strategies can be described under the categories "Getting to know the patient and creating a relationship", "Providing support", "Adapting to individuals' needs" and "Enabling conversations".
CONCLUSION
The findings show that the RNs in this population used strategies that not only took time but also required knowledge about the transition process and required the ability to identify and meet patients' and families' unique needs. Patients' difficult and exposed situation needs to be addressed through a structured follow-up after informing about the change from life-prolonging care to PC. RNs have a unique role of supporting both the patient and the family in the transition from life-prolonging care to PC for patients with incurable disease.
背景
从延长生命的治疗向姑息治疗（PC）的过渡可能具有挑战性，其通常以心理、生理、社会和存在方面的变化为特征。缺乏如何在这一特定护理阶段支持患者和家属的知识，这一领域需要进一步探讨。本研究旨在调查注册护士（RNs）在为绝症患者过渡到姑息治疗时所使用的策略。
方法
本研究采用描述性设计。对在专门的姑息治疗病房工作的 14 名 RN 进行了访谈。使用内容分析法对数据进行分析。
结果
RNs 的策略可分为以下几类：“了解患者并建立关系”、“提供支持”、“适应个体需求”和“促进对话”。
结论
研究结果表明，该人群中的 RN 使用的策略不仅需要时间，还需要了解过渡过程的知识，并需要识别和满足患者和家属独特需求的能力。需要通过在告知从延长生命的治疗到姑息治疗的转变后进行结构化随访来解决患者的困难和脆弱处境。RN 在绝症患者从延长生命的治疗过渡到姑息治疗的过程中，具有支持患者和家属的独特作用。
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