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泰国肿瘤护理人员对患者参与急性癌症护理的看法。

Thai Oncology Nurses' Perceptions of Patient Participation in Acute Cancer Care.

作者信息

Pongthavornkamol Kanaungnit, Khamkon Aphorn, Phligbua Warunee, Cohen Emma, Botti Mari

机构信息

Faculty of Nursing, Mahidol University, Bangkok, Thailand.

Faculty of Nursing, Mahasarakham University, Maha Sarakham Province, Thailand.

出版信息

Asian Nurs Res (Korean Soc Nurs Sci). 2018 Sep;12(3):209-215. doi: 10.1016/j.anr.2018.08.004. Epub 2018 Aug 24.

Abstract

PURPOSE

Patient participation in care is considered a core component of high-quality nursing care and medical treatment. In the context of cancer care in Thailand, we know very little about the way patient participation in care is perceived and enacted. The aim of this study was to explore Thai oncology nurses' perceptions and understandings of patient participation in their own care during hospitalization.

METHODS

A qualitative descriptive research approach using focus groups was applied. Two focus group interviews (N = 16) were conducted with registered nurses who provide care in oncology units of one tertiary care university hospital in Bangkok, Thailand. The transcribed interviews were analyzed using qualitative content analysis.

RESULTS

In this study, nurses were aware of the value of patient participation during hospitalization but acknowledged that current processes to involve patients in their care were not as effective as they could be. Facilitating participation is seen as a means of supporting patients to make decisions independently that are in line with their treatment plans, in particular, decisions related to self-care and illness-related symptoms. This raises the potential for conflict when patients make choices that are contrary to recommendations. Barriers to facilitating participation identified were high clinician workloads and lack of time, and ambiguity of existing guidelines for supporting lifestyle decisions.

CONCLUSION

Facilitating patient participation is complex in acute cancer care. Patient participation is recognized by nurses as a positive way of promoting independence in patients. However, balancing patient autonomy with nurses' perceived professional responsibilities is challenging in practice.

摘要

目的

患者参与护理被视为高质量护理和医疗的核心组成部分。在泰国癌症护理的背景下,我们对患者参与护理的认知和实践方式了解甚少。本研究的目的是探讨泰国肿瘤护理人员对患者在住院期间参与自身护理的看法和理解。

方法

采用焦点小组的定性描述性研究方法。对泰国曼谷一家三级护理大学医院肿瘤科提供护理服务的注册护士进行了两次焦点小组访谈(N = 16)。对转录的访谈内容进行定性内容分析。

结果

在本研究中,护士意识到患者住院期间参与护理的价值,但承认目前让患者参与护理的流程效果不佳。促进参与被视为支持患者做出符合其治疗计划的独立决策的一种方式,特别是与自我护理和疾病相关症状有关的决策。当患者做出与建议相悖的选择时,这就引发了冲突的可能性。确定的促进参与的障碍包括临床医生工作量大、时间不足以及支持生活方式决策的现有指南不明确。

结论

在急性癌症护理中促进患者参与护理很复杂。护士认为患者参与是促进患者独立的积极方式。然而,在实践中平衡患者自主权与护士所感知的专业责任具有挑战性。

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