Julius Center for Health Sciences and Primary Care (EM Kochen, SCCM Teunissen, and MC Kars), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Julius Center for Health Sciences and Primary Care (EM Kochen, SCCM Teunissen, and MC Kars), University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Acad Pediatr. 2022 Aug;22(6):910-917. doi: 10.1016/j.acap.2021.08.015. Epub 2021 Aug 27.
Bereavement care for parents predominantly focuses on care after child loss. However, Health Care Professionals (HCPs) feel responsible for supporting parents who are grieving losses in their child's end-of-life. Preloss care is tailored to the parents' needs, thus highly varying. To better understand the nature of preloss care, this study aims to gain insight into the challenges HCPs encounter while providing care for parents during their child's end-of-life.
Exploratory qualitative research using semistructured interviews with physicians and nurses working in neonatology and pediatrics in 3 university pediatric hospitals and 1 child home care service. A multidisciplinary team thematically analyzed the data.
Twenty-two HCPs participated in this study. From the HCPs' inner perspective, three dyadic dimensions in preloss care delivery were identified that create tension in HCPs: sustaining hope versus realistic prospects, obtaining emotional closeness versus emotional distance, and exploring emotions versus containing emotions. Throughout preloss care delivery, HCPs weighed which strategies to use based on their perception of parental needs, the situation, and their own competencies. HCPs remained with lingering uncertainties on whether the preloss care they provide constituted optimal care.
As a result of the experienced tension, HCPs are at risk for prolonged distress and possibly even compassion fatigue. In order to maintain a positive emotional balance in HCPs, education should focus on adapting positive coping strategies and provide hands-on training. Furthermore, on an institutional level a safe environment should be fostered and well-being could be enhanced through learning by sharing as a team.
丧亲护理主要侧重于儿童死亡后的护理。然而，医疗保健专业人员（HCPs）感到有责任支持在孩子临终时正在丧亲的父母。预先丧亲护理根据父母的需求定制，因此差异很大。为了更好地了解预先丧亲护理的性质，本研究旨在深入了解 HCPs 在为临终儿童的父母提供护理时所面临的挑战。
使用半结构化访谈对在 3 所大学儿科医院和 1 所儿童家庭护理服务中心工作的新生儿科和儿科医生和护士进行探索性定性研究。一个多学科团队对数据进行了主题分析。
22 名 HCPs 参与了这项研究。从 HCPs 的内在视角出发，确定了预先丧亲护理提供中存在的三个对偶维度，这些维度会产生紧张：维持希望与现实前景、获得情感亲近与情感距离、探索情感与控制情感。在整个预先丧亲护理过程中，HCPs 根据他们对父母需求、情况和自身能力的感知来权衡使用哪种策略。HCPs 对他们提供的预先丧亲护理是否构成最佳护理仍然存在挥之不去的不确定性。
由于经历了紧张，HCPs 有长期困扰甚至同情疲劳的风险。为了保持 HCPs 的积极情绪平衡，教育应侧重于适应积极的应对策略，并提供实践培训。此外，在机构层面上，应营造一个安全的环境，并通过团队学习来增强幸福感。
