McGee Julia, Palmer Kelly Elizabeth, Kelly-Brown Joseph, Stevens Erin, Waterman Brittany L, Pawlik Timothy M
The Ohio State University, Columbus, OH, USA.
The James Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
J Cancer Educ. 2023 Feb;38(1):301-308. doi: 10.1007/s13187-021-02115-x. Epub 2021 Nov 12.
The current study evaluated formal training around spiritual care for healthcare providers and the relationships between that training, perceived barriers to spiritual care, and frequency of inquiry around spiritual topics. A mixed methods explanatory sequential design was used. Quantitative methods included an online survey administered to providers at The Ohio State University Comprehensive Cancer Center. Main and interactive effects of formal training and barriers to spiritual care on frequency of inquiry around spiritual topics were assessed with two-way ANOVA. Qualitative follow-up explored provider strategies to engage spiritual topics. Among 340 quantitative participants, most were female (82.1%) or White (82.6%) with over one-half identifying as religious (57.5%). The majority were nurses (64.7%) and less than 10% of all providers (n = 26) indicated formal training around spiritual care. There were main effects on frequency of inquiry around spiritual topics for providers who indicated "personal discomfort" as a barrier (p < 0.001), but not formal training (p = 0.526). Providers who indicated "personal discomfort" as a barrier inquired about spirituality less frequently, regardless of receiving formal training (M = 8.0, SD = 1.41) or not (M = 8.76, SD = 2.96). There were no interactive effects between training and "may offend patients" or "personal discomfort" (p = 0.258 and 0.125, respectively). Qualitative analysis revealed four strategies with direct and indirect approaches: (1) permission-giving, (2) self-awareness/use-of-self, (3) formal assessment, and (4) informal assessment. Training for providers should emphasize self-awareness to address intrapersonal barriers to improve the frequency and quality of spiritual care for cancer patients.
本研究评估了针对医疗服务提供者的精神护理方面的正规培训，以及该培训、感知到的精神护理障碍与围绕精神主题的询问频率之间的关系。采用了混合方法解释性序列设计。定量方法包括对俄亥俄州立大学综合癌症中心的提供者进行的在线调查。使用双向方差分析评估正规培训和精神护理障碍对围绕精神主题的询问频率的主要和交互作用。定性随访探讨了提供者参与精神主题的策略。在340名定量参与者中，大多数是女性（82.1%）或白人（82.6%），超过一半的人认为自己有宗教信仰（57.5%）。大多数是护士（64.7%），所有提供者中不到10%（n = 26）表示接受过精神护理方面的正规培训。对于将“个人不适”视为障碍的提供者，围绕精神主题的询问频率存在主要影响（p < 0.001），但正规培训没有（p = 0.526）。将“个人不适”视为障碍的提供者，无论是否接受正规培训，询问灵性问题的频率都较低（接受培训的M = 8.0，SD = 1.41；未接受培训的M = 8.76，SD = 2.96）。培训与“可能冒犯患者”或“个人不适”之间没有交互作用（分别为p = 0.258和0.125）。定性分析揭示了四种直接和间接方法的策略：（1）给予许可，（2）自我意识/自我运用，（3）正式评估，（4）非正式评估。对提供者的培训应强调自我意识，以解决个人内部障碍，提高对癌症患者精神护理的频率和质量。
