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从无力到被认可——缓和医疗临床医生痛苦体验的意义

From powerlessness to recognition the meaning of palliative care clinicians' experience of suffering.

机构信息

Psychology Department, Université du Québec à Montréal , Montréal, Québec, Canada.

Researcher, Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices , Montreal, Québec, Canada.

出版信息

Int J Qual Stud Health Well-being. 2020 Dec;15(1):1852362. doi: 10.1080/17482631.2020.1852362.

Abstract

Palliative care (PC) clinicians work alongside people who are at the end of their lives. These patients face death and suffering, which may also cause significant suffering for the PC clinicians themselves. Previous studies suggest that a significant number of PC professionals suffer from compassion fatigue, vicarious trauma and burnout. However, very few studies have attempted to better understand the meaning of PC clinicians' lived experience of suffering in its complexity and intricacy. Drawing upon Interpretative Phenomenological Analysis (IPA), this study aimed to explore the PC clinicians' experience of suffering from a phenomenological and existential perspective. In-depth interviews were conducted with twenty-one specialized PC clinicians who were all part of the same multidisciplinary team. Interviews were analysed using IPA. The three emerging essential themes describing the meaning of clinicians' suffering were 1) Suffering as powerlessness; 2) suffering as non-recognition and 3) easing suffering: the promise of recognition. Result interpretation was based on Paul Ricoeur's existential phenomenology of suffering and recognition. The conclusion calls for support initiatives and interventions aimed at promoting recognition among PC clinicians on personal, professional, and institutional levels.

摘要

姑息治疗(PC)临床医生与生命末期的患者并肩工作。这些患者面临死亡和痛苦,这也可能给 PC 临床医生自身带来巨大的痛苦。先前的研究表明,相当数量的 PC 专业人员患有同情疲劳、替代性创伤和倦怠。然而,很少有研究试图从现象学和存在主义的角度更好地理解 PC 临床医生在其复杂性和复杂性中所经历的痛苦的含义。本研究采用解释现象学分析(IPA),旨在从现象学和存在主义的角度探讨 PC 临床医生的痛苦体验。对 21 名专门从事姑息治疗的临床医生进行了深入访谈,他们都属于同一个多学科团队。使用 IPA 对访谈进行了分析。描述临床医生痛苦含义的三个主要主题是:1)痛苦即无能为力;2)痛苦即不被认可;3)减轻痛苦:认可的承诺。结果解释基于保罗·利科的痛苦和认可的存在现象学。结论呼吁采取支持举措和干预措施,旨在在个人、专业和机构层面促进对 PC 临床医生的认可。

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