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“这不是他们所期望的”:医院姑息治疗志愿者的角色和经验的系统评价和叙述性综合。

'It's not what they were expecting': A systematic review and narrative synthesis of the role and experience of the hospital palliative care volunteer.

机构信息

School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia.

Centre for Quality and Patient Safety Research, Deakin University, Geelong, VIC, Australia.

出版信息

Palliat Med. 2020 May;34(5):589-604. doi: 10.1177/0269216319899025. Epub 2020 Feb 17.

Abstract

BACKGROUND

Volunteers make a major contribution to palliative care but little is known specifically about hospital palliative care volunteers.

AIM

The aim of this study was to understand the role and experience of hospital palliative care volunteers.

DESIGN

Systematic review and narrative synthesis.

DATA SOURCES

CINAHL, Embase, Medline, PsycINFO, PubMed and three dissertation databases were searched from inception to June 2019. A forward and backward search of included papers in key journals was also undertaken. Records were independently assessed against inclusion criteria by authors. Included papers were assessed for quality, but none were excluded.

RESULTS

In total, 14 papers were included. Hospital palliative care volunteers were mostly female, aged above 40 years, and training varied considerably. Volunteers faced unique challenges in supporting dying patients due to the nature of hospital care, rapid patient turnover and the once-off nature of support. Volunteer roles were diverse, with some providing hands-on care, but most focused on 'being with' the dying patient. Volunteers were appreciated for providing psychosocial support, seen as complementary to, rather than replacing the work of health professionals. Given volunteers were often required to work across multiple wards, establishing positive work relationships with health professionals was challenging. Divergent views about whether the volunteer was part of or external to the team impacted volunteers' experience and perceptions of the value of their contribution.

CONCLUSION

Hospital palliative care volunteers face unique challenges in supporting terminally ill patients. Volunteer support in hospital settings is possible and appropriate, if sufficient support is available to mitigate the challenges associated with complex, high-acuity care.

摘要

背景

志愿者为缓和医疗做出了重大贡献,但对于医院缓和医疗志愿者的具体情况知之甚少。

目的

本研究旨在了解医院缓和医疗志愿者的角色和体验。

设计

系统评价和叙述性综合。

资料来源

从建库开始,对 CINAHL、Embase、Medline、PsycINFO、PubMed 和三个论文数据库进行了检索,并对主要期刊中包含的论文进行了前向和后向搜索。作者独立评估记录是否符合纳入标准。对纳入的论文进行了质量评估,但没有排除任何论文。

结果

共纳入 14 篇论文。医院缓和医疗志愿者主要为女性,年龄在 40 岁以上,培训差异较大。由于医院护理的性质、患者快速周转和一次性支持,志愿者在支持临终患者方面面临独特的挑战。志愿者的角色多种多样,有些提供实际护理,但大多数专注于陪伴临终患者。志愿者提供的心理社会支持受到赞赏,被认为是对卫生专业人员工作的补充,而不是替代。鉴于志愿者通常需要在多个病房工作,与卫生专业人员建立积极的工作关系具有挑战性。关于志愿者是团队的一部分还是团队之外的不同观点,影响了志愿者对其工作经验和贡献价值的看法。

结论

医院缓和医疗志愿者在支持绝症患者方面面临独特的挑战。如果有足够的支持来减轻与复杂、高重症护理相关的挑战,那么在医院环境中提供志愿者支持是可行和适当的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10f1/7222697/8f8d1882ab50/10.1177_0269216319899025-fig1.jpg

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