Fujita Ayaka, Hamada Yuko
Division of Nursing Science, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Pediatr Int. 2019 Jul;61(7):658-663. doi: 10.1111/ped.13891. Epub 2019 Jul 9.
A child's death affects not only family members but also the health-care professionals involved in patient care. The education system for bereavement care in Japan, however, is not set up in a systematic way, and the care provided is based on the individual experience of the health-care professional. The aim of this study was to investigate pediatrician awareness of and actual circumstances involved in bereavement care in Japan.
A qualitative descriptive study was conducted at four facilities in Japan. Data collected using semi-structured interviews of 11 pediatricians were assessed using inductive qualitative analysis.
Pediatrician recognition of the elements of bereavement care was categorized as follows: (i) developing relationships with families before a child's death is important in bereavement care; (ii) after the child dies, family involvement is left to the doctor's discretion; (iii) coping with a child's death myself through past experience is essential; (iv) doctors involved in a child's death also experience mental burden; and (v) a system for the family's bereavement care must be established. Two categories were established according to actual circumstances involved in bereavement care: (i) attention must be given to the emotions of the families who lost a child; and (ii) doctor involvement with bereaved families depends on doctor awareness and expertise.
Japanese pediatricians provided bereavement care to families who lost their children in a non-systematic manner. This is necessitates improvement of the self-care of health-care professionals with regard to grief by improving bereavement care-related education. Additionally, health-care professionals must be trained, and a national-level provision system must be established to provide high-quality bereavement care to families who lose a child.
儿童死亡不仅会影响家庭成员,还会对参与患儿护理的医护人员产生影响。然而,日本针对丧亲之痛护理的教育体系并未系统建立,所提供的护理基于医护人员的个人经验。本研究旨在调查日本儿科医生对丧亲之痛护理的认知及实际情况。
在日本的四个机构开展了一项定性描述性研究。通过对11名儿科医生进行半结构化访谈收集的数据,采用归纳性定性分析进行评估。
儿科医生对丧亲之痛护理要素的认知分类如下:(i)在儿童死亡前与家庭建立关系对丧亲之痛护理很重要;(ii)儿童死亡后,是否让家庭参与由医生自行决定;(iii)通过过往经验来应对儿童死亡对自身而言至关重要;(iv)参与儿童死亡事件的医生也会经历精神负担;(v)必须建立针对家庭丧亲之痛护理的体系。根据丧亲之痛护理的实际情况分为两类:(i)必须关注失去孩子的家庭的情绪;(ii)医生与丧亲家庭的接触取决于医生的认知和专业知识。
日本儿科医生对失去孩子的家庭提供的丧亲之痛护理缺乏系统性。这就需要通过改进与丧亲之痛护理相关的教育,来改善医护人员在悲伤方面的自我护理。此外,必须对医护人员进行培训,并建立国家级的提供体系,以便为失去孩子的家庭提供高质量的丧亲之痛护理。