Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
Eur J Oncol Nurs. 2019 Aug;41:56-63. doi: 10.1016/j.ejon.2019.05.012. Epub 2019 Jun 1.
The objective of this mixed-methods study was to explore the experiences and perspectives of Transplant Nurses (TNs) in caring for related donors (RDs).
In this mixed-methods study, both quantitative and qualitative data were collected from semi-structured interviews with seven TNs from two clinical hospitals. Closed and multiple-choice questions regarding the organisation of RD care were administered in addition to an in-depth exploration of TN experiences and perspectives of RD care. Interviews were audio-recorded, transcribed, and qualitative data was subjected to thematic analyses.
The analysis identified 5 themes relating to RD care: managing complex family dynamics and ambivalence; concerns about RD psychological adjustment; identifying and correcting RD misperceptions; limited guidelines and structured processes; limited training for the role and access to supervision. Five themes were identified describing the barriers to delivering RD care: RDs unwilling to express their concerns; language; time constraints; medical priority of clinicians; biomedical focus of TNs. All TNs agreed they would like additional training in the psychosocial management of RDs. TNs identified key areas for improvement, including psychosocial support and educational material.
Our results highlight the significant role of TNs in RD care, and underline issues specific to the current RD care environment. Lack of training for the role and limited guidelines addressing RD care management are key issues which may detrimentally affect RD care. The pivotal role of TNs must be acknowledged and supported by improving TN training and implementing clear guidelines for the management of RDs. The trial has been registered on the publicly accessible register: www.clinicaltrials.gov site with the identifier ACTRN12617000407392.
本混合方法研究旨在探讨移植护士（TNs）在照顾相关供者（RDs）方面的经验和观点。
在这项混合方法研究中，从两家临床医院的七名 TN 中收集了定量和定性数据。除了深入探讨 TN 对 RD 护理的经验和观点外，还对 RD 护理的组织进行了半结构化访谈，并采用了封闭式和多项选择题。访谈进行了录音、转录，并对定性数据进行了主题分析。
分析确定了与 RD 护理相关的 5 个主题：管理复杂的家庭动态和矛盾心理；对 RD 心理调整的关注；识别和纠正 RD 的误解；有限的指导方针和结构化流程；角色培训有限，监督机会有限。描述提供 RD 护理障碍的 5 个主题：RD 不愿意表达他们的担忧；语言；时间限制；临床医生对医学的重视；TNs 的生物医学重点。所有 TNs 都同意他们希望在 RD 的心理社会管理方面接受额外的培训。TNs 确定了需要改进的关键领域，包括社会心理支持和教育材料。
我们的研究结果强调了 TNs 在 RD 护理中的重要作用，并强调了当前 RD 护理环境中的具体问题。缺乏对该角色的培训以及缺乏针对 RD 护理管理的指导方针是可能对 RD 护理产生不利影响的关键问题。必须承认 TNs 的关键作用，并通过改进 TN 培训和实施 RD 管理的明确指南来支持他们。该试验已在公共可访问的注册处进行注册：www.clinicaltrials.gov 网站，标识为 ACTRN12617000407392。
