Zheng Ruishuang, Guo Qiaohong, Chen Zhiqian, Ma Lili, McClement Susan
Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
School of Nursing, Capital Medical University, Beijing, China.
Asia Pac J Oncol Nurs. 2021 Jan 29;8(2):139-146. doi: 10.4103/apjon.apjon_62_20. eCollection 2021 Mar-Apr.
Although there has been an increasing emphasis on assisting nurses with providing quality hospice care to patients and family members, few studies have explored the challenges that oncology nurses face when delivering hospice care in the Chinese cultural context. The objective of this study was to elucidate the challenges for oncology nurses in providing hospice care for terminally ill cancer patients in mainland China.
A descriptive qualitative study with purposive sampling using audio-recorded fact-to-face interviews. A total of 13 hospice nurses from four hospitals in Beijing, mainland China, participated in this study. Data collection was from April to June 2019, and thematic analysis method was used to analyze the data.
Challenges identified by hospice nurses in providing hospice care for terminally ill cancer patients included: (1) public misperception on hospice care, (2) lack of financial support, (3) fear of medical disputes and legal action, (4) shortage of human resources, (5) insufficient specialization and lack of "hierarchy" training on hospice care, (6) inexperience in communication skills, and (7) lack of self-care and stress management skills.
It is imperative and critical for the government, health-care institutions, and hospice care providers to clearly understand the challenges that currently exist in providing hospice nursing. Joint efforts are needed to overcome those challenges, which might result in qualified hospice nurses and provide evidence for further development of hospice care in mainland China.
尽管越来越强调协助护士为患者及其家属提供优质的临终关怀服务，但很少有研究探讨中国文化背景下肿瘤专科护士在提供临终关怀服务时所面临的挑战。本研究的目的是阐明中国大陆肿瘤专科护士在为晚期癌症患者提供临终关怀服务时所面临的挑战。
采用目的抽样法进行描述性定性研究，通过面对面访谈进行录音。中国大陆北京4家医院的13名临终关怀护士参与了本研究。数据收集时间为2019年4月至6月，并采用主题分析法对数据进行分析。
临终关怀护士在为晚期癌症患者提供临终关怀服务时所面临的挑战包括：（1）公众对临终关怀服务的误解；（2）缺乏资金支持；（3）对医疗纠纷和法律诉讼的担忧；（4）人力资源短缺；（5）临终关怀服务专业化不足且缺乏“层级式”培训；（6）沟通技巧缺乏经验；（7）缺乏自我护理和压力管理技能。
政府、医疗机构和临终关怀服务提供者必须清楚地认识到目前在提供临终关怀护理方面存在的挑战。需要共同努力克服这些挑战，这可能会培养出合格的临终关怀护士，并为中国大陆临终关怀服务的进一步发展提供依据。
