Weisse Carol S, Melekis Kelly, Hutchins Bailey
1 Department of Psychology, Union College, Olin 110C, Schenectady, NY, USA.
2 Department of Social Work, Skidmore College, 815 N Broadway, Saratoga Springs, NY, USA.
Am J Hosp Palliat Care. 2019 Jun;36(6):538-545. doi: 10.1177/1049909118820844. Epub 2018 Dec 25.
Health-care providers report a lack of training in end-of-life care and limited opportunities exist to learn about the dying process in home settings where most prefer to die.
To evaluate the effectiveness of a Community Action, Research, and Education (CARE) program designed to promote empathy and self-efficacy communicating with and caring for terminally ill patients.
This mixed-methods study collected pre-post data from 18 undergraduates (7 men≤ 11 women) in a 8-week immersive program where they served as primary caregivers in residential homes for the dying providing 200 hours of bedside care to hospice patients during their final days. Quantitative measures assessed empathy using the Jefferson Scale of Empathy-Health Professions (JSE-HPS) version and self-efficacy using a 20-question palliative care skill assessment. Qualitative analyses were conducted on reflective journals to further assess knowledge, skill, and value development.
Paired t tests revealed significant increases in empathy ( P < .05) and self-efficacy ( P < .001) to provide end-of-life care. Thematic analysis of reflective journals further demonstrated specific instances of empathy and self-efficacy.
Community-run residential homes for the dying offer a unique opportunity for skills training in end-of-life care. The opportunity to serve as a caregiver for the dying improved students' confidence and ability to provide empathic patient- and family-centered end-of-life care to hospice patients in their final days.
医疗保健提供者报告称缺乏临终关怀方面的培训，而且在大多数人希望离世的家庭环境中，了解死亡过程的机会有限。
评估一项社区行动、研究与教育（CARE）项目的有效性，该项目旨在提高与晚期绝症患者沟通及护理时的同理心和自我效能感。
这项混合方法研究在一个为期8周的沉浸式项目中收集了18名本科生（7名男性≤11名女性）的前后数据，在该项目中，他们在临终关怀养老院担任主要护理人员，在临终患者生命的最后几天为其提供200小时的床边护理。定量测量使用杰斐逊同理心量表-健康专业版（JSE-HPS）评估同理心，使用一项包含20个问题的姑息治疗技能评估来评估自我效能感。对反思日志进行定性分析，以进一步评估知识、技能和价值观的发展。
配对t检验显示，在提供临终关怀方面，同理心（P<.05）和自我效能感（P<.001）有显著提高。对反思日志的主题分析进一步证明了同理心和自我效能感的具体事例。
社区经营的临终关怀养老院为临终关怀技能培训提供了独特的机会。担任临终患者护理人员的机会提高了学生在临终患者生命最后几天为其提供以患者和家庭为中心的同理心临终关怀的信心和能力。
