Dicks Sean G, Burkolter Nadia, Jackson Lyndall C, Northam Holly L, Boer Douglas P, van Haren Frank M P
Faculty of Health, University of Canberra, Canberra, ACT, Australia.
Canberra Health Services, Canberra, ACT, Australia.
Transplant Direct. 2019 Dec 12;6(1):e512. doi: 10.1097/TXD.0000000000000957. eCollection 2020 Jan.
The organ donation process is complex and stressful for the family of the potential donor and members of the multidisciplinary team who may experience grief, ethical dilemmas, vicarious trauma, or compassion fatigue. Several studies each explore the role of a specific healthcare group and the impact of inhospital processes on group members. We conducted a systematic literature search to identify such studies and a qualitative synthesis to consolidate findings and highlight features of the interaction and relationships between role players. Our results suggest that, while healthcare professionals have different roles, attitudes, and views, the experience of stressors and interdisciplinary tension is common. Nevertheless, staff are united by the goal of caring for the patient and family. We therefore propose that, while focusing on bereavement care and other aspects of the family's experience, staff can find other shared goals and develop understanding, trust, empathy, and respect for each other's positions, thereby improving functioning in the complex adaptive system that forms at this time. Education and training can equip staff to facilitate anticipatory mourning, family-led activities, and a meaningful parting from their relative, assisting families with their grief and increasing staff members' efficacy, confidence, and interdisciplinary teamwork. Knowledge of systems thinking and opportunities to share ideas and experiences will enable staff to appreciate each other's roles, while supportive mentors, self-care strategies, and meaningful feedback between role players will foster healthy adjustment and shared learning. A focus on psychosocial outcomes such as family satisfaction with the process, collaboration within the multidisciplinary team, and reduction in the role stress of healthcare professionals will contribute to family well-being as well as personal and professional growth for staff.
器官捐赠过程对于潜在捐赠者的家属以及多学科团队成员来说是复杂且充满压力的,他们可能会经历悲伤、伦理困境、替代性创伤或同情疲劳。几项研究分别探讨了特定医疗保健群体的作用以及医院内流程对团队成员的影响。我们进行了系统的文献检索以识别此类研究,并进行了定性综合分析以巩固研究结果,并突出角色参与者之间互动和关系的特征。我们的结果表明,虽然医疗保健专业人员有不同的角色、态度和观点,但压力源和跨学科紧张关系的经历是常见的。尽管如此,工作人员因照顾患者和家属的目标而团结在一起。因此,我们建议,在关注丧亲之痛护理和家庭经历的其他方面时,工作人员可以找到其他共同目标,并培养对彼此立场的理解、信任、同理心和尊重,从而改善此时形成的复杂适应系统的运作。教育和培训可以使工作人员能够促进预期哀悼、家庭主导的活动以及与亲人有意义的告别,帮助家庭应对悲伤,并提高工作人员的效能、信心和跨学科团队合作能力。系统思维知识以及分享想法和经验的机会将使工作人员能够理解彼此的角色,而支持性的导师、自我护理策略以及角色参与者之间有意义的反馈将促进健康的调整和共同学习。关注心理社会结果,如家庭对该过程的满意度、多学科团队内部的协作以及医疗保健专业人员角色压力的减轻,将有助于家庭幸福以及工作人员的个人和职业成长。