Sutherland Sheera, Durley Kirsty E, Gillies Kirsty, Glogowska Margaret, Lasserson Daniel S, Pugh Christopher, Lowney Aoife C
Oxford Kidney Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
Department of Palliative Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
BMJ Open. 2021 Jun 22;11(6):e046537. doi: 10.1136/bmjopen-2020-046537.
To explore the impact of the death of a patient in the haemodialysis unit on fellow patients.
We interviewed patients on dialysis in a tertiary dialysis centre using semistructured interviews. We purposively sampled patients who had experienced the death of a fellow patient. After interviews were transcribed, they were thematically analysed by independent members of the research team using inductive analysis. Input from the team during analysis ensured the rigour and quality of the findings.
10 participants completed the interviews (6 females and 4 males with an age range of 42-88 years). The four core themes that emerged from the interviews included: (1) patients' relationship to haemodialysis, (2) how patients define the haemodialysis community, (3) patients' views on death and bereavement and (4) patients' expectations around death in the dialysis community. Patients noticed avoidance behaviour by staff in relation to discussing death in the unit and would prefer a culture of open acknowledgement.
Staff acknowledgement of death is of central importance to patients on haemodialysis who feel that the staff are part of their community. This should guide the development of appropriate bereavement support services and a framework that promotes the provision of guidance for staff and patients in this unique clinical setting. However, the authors acknowledge the homogenous sample recruited in a single setting may limit the transferability of the study. Further work is needed to understand diverse patient and nurse experiences and perceptions when sharing the knowledge of a patient's death and how they react to loss.
探讨血液透析单元内患者死亡对其他患者的影响。
我们在一家三级透析中心对接受透析的患者进行了半结构化访谈。我们有目的地抽取了经历过同组患者死亡的患者。访谈转录后，由研究团队的独立成员采用归纳分析法进行主题分析。分析过程中团队的投入确保了研究结果的严谨性和质量。
10名参与者完成了访谈（6名女性和4名男性，年龄范围为42 - 88岁）。访谈中出现的四个核心主题包括：（1）患者与血液透析的关系，（2）患者如何定义血液透析群体，（3）患者对死亡和丧亲之痛的看法，以及（4）患者对透析群体中死亡的期望。患者注意到工作人员在单位内避免谈论死亡的行为，更倾向于一种公开承认的文化。
工作人员对死亡的承认对血液透析患者至关重要，他们认为工作人员是其群体的一部分。这应为制定适当的丧亲支持服务以及一个促进在这种独特临床环境中为工作人员和患者提供指导的框架提供指导。然而，作者承认在单一环境中招募的同质样本可能会限制该研究的可推广性。需要进一步开展工作，以了解在分享患者死亡信息时不同患者和护士的经历及看法，以及他们对丧失的反应。
