Wallerstedt Birgitta, Benzein Eva, Schildmeijer Kristina, Sandgren Anna
Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Sweden.
Center for Collaborative Palliative Care, Linnaeus University, Sweden.
Scand J Caring Sci. 2019 Mar;33(1):77-84. doi: 10.1111/scs.12603. Epub 2018 Aug 13.
Despite increased attention and knowledge in palliative care, there is still confusion concerning how to interpret the concept of palliative care and implement it in practice. This can result in difficulties for healthcare professionals in identifying patients whom would benefit from palliative care, which, in turn, could lead to a delay in meeting patients' needs.
To explore healthcare professionals' perceptions of palliative care.
Data were collected through twelve interprofessional focus group interviews in community care and hospital wards in south Sweden (n = 74). All interviews were analysed with latent content analysis.
Three domains were revealed: first, a blurred conceptual understanding as participants described palliative care using synonyms, diagnoses, phases, natural care and holism; second, a challenge to communicate transitions concerned the importance of how and when the transition to palliative care was communicated and documented; finally, a need for interprofessional collaboration was described as well as the consequences for severely ill persons, relatives and healthcare professionals when it was not established.
The perceptions about how to interpret palliative care differed as well as when palliative care should be offered and decided, which might have practical consequences. How long a person has left to live is of great significance for decision-making, caregiving and preparation in palliative care. The challenge is to use interprofessional communication to promote understanding and collaborate across varied care levels. Integrating palliative care across diverse care levels could be one way to reduce the ambiguity of palliative care.
尽管对姑息治疗的关注度和了解有所增加,但在如何解释姑息治疗的概念以及在实践中实施该概念方面仍存在困惑。这可能导致医疗保健专业人员难以识别能从姑息治疗中受益的患者,进而可能导致满足患者需求的延迟。
探讨医疗保健专业人员对姑息治疗的看法。
通过在瑞典南部社区护理和医院病房进行的12次跨专业焦点小组访谈收集数据(n = 74)。所有访谈均采用潜在内容分析法进行分析。
揭示了三个领域:第一,概念理解模糊,因为参与者使用同义词、诊断、阶段、自然护理和整体论来描述姑息治疗;第二,沟通转变面临挑战,涉及到如何以及何时传达和记录向姑息治疗的转变的重要性;最后,描述了对跨专业协作的需求以及未建立协作时对重症患者、亲属和医疗保健专业人员的影响。
对于如何解释姑息治疗以及何时提供和决定姑息治疗的看法存在差异,这可能会产生实际后果。一个人还能活多久对于姑息治疗中的决策、护理和准备具有重要意义。挑战在于利用跨专业沟通来促进理解并在不同护理层面进行协作。在不同护理层面整合姑息治疗可能是减少姑息治疗模糊性的一种方法。