School of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Palliative Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.
BMC Palliat Care. 2020 Jul 1;19(1):96. doi: 10.1186/s12904-020-00608-y.
Spiritual care is frequently cited as a key component of hospice care in Taiwanese healthcare and beyond. The aim of this research is to gauge physicians and nurses' self-reported perspectives and clinical practices on the roles of their professions in addressing spiritual care in an inpatient palliative care unit in a tertiary hospital with Buddhist origins.
We performed semi-structured interviews with physicians and nurses working in hospice care over a year on their self-reported experiences in inpatient spiritual care. We utilized a directed approach to qualitative content analysis to identify themes emerging from interviews.
Most participants identified as neither spiritual nor religious. Themes in defining spiritual care, spiritual distress, and spiritual care challenges included understanding patient values and beliefs, fear of the afterlife and repercussions of poor family relationships, difficulties in communication, the patient's medical state, and a perceived lack of preparedness and time to deliver spiritual care.
Our study suggests that Taiwanese physicians and nurses overall find spiritual care difficult to define in practice and base perceptions and practices of spiritual care largely on patient's emotional and physical needs. Spiritual care is also burdened logistically by difficulties in navigating family and cultural dynamics, such as speaking openly about death. More research on spiritual care in Taiwan is needed to define the appropriate training, practice, and associated challenges in provision of spiritual care.
精神关怀经常被认为是台湾医疗保健乃至其他地区临终关怀的一个关键组成部分。本研究旨在评估医生和护士对其专业在佛教背景的三级医院住院姑息治疗单位提供精神关怀方面的角色的自我报告观点和临床实践。
我们对从事临终关怀工作的医生和护士进行了为期一年的半结构化访谈，了解他们在住院精神关怀方面的自我报告经验。我们采用定向方法对定性内容进行分析，以确定访谈中出现的主题。
大多数参与者认为自己既不是精神上的也不是宗教上的。在定义精神关怀、精神困扰和精神关怀挑战方面的主题包括了解患者的价值观和信仰、对来世的恐惧和不良家庭关系的后果、沟通困难、患者的医疗状况以及缺乏提供精神关怀的准备和时间。
我们的研究表明，台湾的医生和护士总体上发现精神关怀在实践中难以定义，并将精神关怀的看法和实践主要基于患者的情感和身体需求。精神关怀在很大程度上还受到家庭和文化动态的影响，例如难以公开谈论死亡，在后勤方面也存在困难。需要对台湾的精神关怀进行更多研究，以确定提供精神关怀的适当培训、实践和相关挑战。
