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日本儿科的哀伤护理:儿科医生在实践中的认知

Bereavement care in Japanese pediatrics: Pediatrician awareness in practice.

作者信息

Fujita Ayaka, Hamada Yuko

机构信息

Division of Nursing Science, Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Pediatr Int. 2019 Jul;61(7):658-663. doi: 10.1111/ped.13891. Epub 2019 Jul 9.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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