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卫生专业人员对姑息治疗中希望的作用和与患者沟通挑战的看法:系统叙事评价。

Health professionals' view on the role of hope and communication challenges with patients in palliative care: A systematic narrative review.

机构信息

Swiss Paraplegic Research, Person-centered Healthcare & Health Communication Group Guido A, Zäch Strasse 4, 6207 Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland.

Consultation-Liaison Psychiatry Service, Organizzazione Sociopsichiatrica Cantonale, Via Agostino Maspoli 6, 6850 Mendrisio, Switzerland.

出版信息

Patient Educ Couns. 2022 Jun;105(6):1470-1487. doi: 10.1016/j.pec.2021.09.025. Epub 2021 Sep 21.

Abstract

OBJECTIVE

To identify health professionals' (HPs) perspectives on the role of hope and the main challenges faced when communicating with patients in palliative care (PC).

METHODS

Search on PubMed, Scopus, SocIndex, Cochrane, and Web of Science using: palliat*, palliative care, palliative medicine, hospice care, terminal care, long term care, supportive care, end of life (EOL) care and hope*, followed by a thematic narrative analysis.

RESULTS

Thirty-five studies were included. HPs' views were grouped in: Bringing out hope and Taking down hope. HPs believe that hope is elicited through a personal patient-provider bond and exhibited through medical treatment delivery. HPs face difficulties when delivering prognosis, referring to hospice, and providing palliation.

CONCLUSION

Hope is conveyed through verbal and non-verbal communication. HPs struggle to account for hope's shifting character, challenging the engagement in EOL discussions.

PRACTICAL IMPLICATIONS

Findings show a patient-provider clash of perspectives, suggesting a gap in acknowledging the shifting nature of hope. An important question emerges: Are the existing theories of hope that are solely explained from a patient experience relevant for HPs' own interpretation? Investigating the HPs' attitudes gathered in collective experiences in PC, might contribute to answering the question in the context of building more constructive communication approaches.

摘要

目的

确定卫生专业人员(HPs)对希望在姑息治疗(PC)中与患者沟通时的作用以及面临的主要挑战的看法。

方法

在 PubMed、Scopus、SocIndex、Cochrane 和 Web of Science 上使用以下关键词进行搜索:palliat*、palliative care、palliative medicine、hospice care、terminal care、long term care、supportive care、end of life (EOL) care 和 hope*,然后进行主题叙事分析。

结果

共纳入 35 项研究。HPs 的观点分为:引出希望和消除希望。HPs 认为希望是通过个人医患关系产生的,并通过提供医疗治疗来表现。HPs 在提供预后、转介临终关怀和提供姑息治疗方面存在困难。

结论

希望通过言语和非言语沟通来传达。HPs 在解释希望的变化特征时遇到困难,这使得他们难以进行临终讨论。

实际意义

研究结果显示出医患观点的冲突,表明在承认希望的变化性质方面存在差距。出现了一个重要问题:仅仅从患者体验解释的希望的现有理论是否与 HPs 自己的解释相关?在姑息治疗中集体经验中调查 HPs 的态度,可能有助于在构建更具建设性的沟通方法的背景下回答这个问题。

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