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道德困境:通过汇报来缓解的框架。

Moral Distress: A Framework for Offering Relief through Debrief.

机构信息

Sutter Health Program in Medicine and Human Values, San Francisco, CA USA.

出版信息

J Clin Ethics. 2020 Winter;31(4):364-371.

Abstract

Moral distress, if left unaddressed, leads to a number of harmful emotions and behaviors that take a toll on the personal and professional well-being of healthcare workers. In this article, a clinical case is used to illustrate a moral distress debriefing framework that can be utilized by clinical ethicists and healthcare professionals with the appropriate skill set. The first part of the framework is preparatory; it includes guidance on how to identify the needs of healthcare providers, set goals for a debriefing session, gather relevant information, and plan the logistics of the meeting. The second part of the framework is implemental; it outlines an eight-step method to conduct the session from beginning to end. It describes how to constructively reflect on the experience, explore emotional responses, share coping strategies, and identify take-aways for future positive outcomes. This framework can be used to empower healthcare team members to deal with moral distress and be better equipped to handle challenging situations.

摘要

道德困境如果得不到解决,会导致一系列有害的情绪和行为,从而影响医疗保健工作者的个人和职业健康。本文通过一个临床案例,阐述了一个道德困境汇报框架,具有相应技能的临床伦理学家和医疗保健专业人员可以使用该框架。框架的第一部分是准备阶段,包括指导如何识别医疗保健提供者的需求、为汇报会议设定目标、收集相关信息以及规划会议的后勤工作。框架的第二部分是实施阶段,概述了从开始到结束进行会议的八步方法。它描述了如何建设性地反思经验、探索情绪反应、分享应对策略,并为未来的积极结果确定要点。该框架可以用来增强医疗团队成员应对道德困境的能力,并更好地应对具有挑战性的情况。

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