文化冲突：一项关于在急性病房引入姑息治疗咨询团队的人种志研究
Cultures that collide: an ethnographic study of the introduction of a palliative care consultation team on acute wards.
作者信息
Friedrichsen Maria, Hajradinovic Yvonne, Jakobsson Maria, Brachfeld Kerstin, Milberg Anna
机构信息
Palliative Education and Research Centre in Region Östergötland, Vrinnevi Hospital, 601 82, Norrköping, Sweden.
Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden.
出版信息
BMC Palliat Care. 2021 Nov 21;20(1):180. doi: 10.1186/s12904-021-00877-1.
BACKGROUND
Acute care and palliative care (PC) are described as different incompatible organisational care cultures. Few studies have observed the actual meeting between these two cultures. In this paper we report part of ethnographic results from an intervention study where a palliative care consultation team (PCCT) used an integrative bedside education approach, trying to embed PC principles and interventions into daily practice in acute wards.
PURPOSE
To study the meeting and interaction of two different care cultures, palliative care and curative acute wards, when a PCCT introduces consulting services to acute wards regarding end-of-life palliative care, focusing on the differences between the cultures.
METHODS
An ethnographic study design was used, including observations, interviews and diary entries. A PCCT visited acute care wards during 1 year. The analysis was inspired by Spradleys ethnography.
RESULTS
Three themes were found: 1) Anticipations meets reality; 2) Valuation of time and prioritising; and 3) The content and creation of palliative care.
CONCLUSION
There are many differences in values, and the way PC are provided in the acute care wards compared to what a PCCT expects. The didactic challenges are many and the PC require effort.
背景
急性护理和姑息治疗（PC）被描述为不同的、不相容的组织护理文化。很少有研究观察到这两种文化之间的实际交汇情况。在本文中，我们报告了一项干预研究的部分人种学研究结果，在该研究中，一个姑息治疗咨询团队（PCCT）采用了一种综合床边教育方法，试图将PC原则和干预措施融入急性病房的日常实践中。
目的
当PCCT就临终姑息治疗向急性病房引入咨询服务时，研究姑息治疗和治愈性急性病房这两种不同护理文化的交汇和相互作用，重点关注文化之间的差异。
方法
采用人种学研究设计，包括观察、访谈和日记记录。一个PCCT在1年的时间里走访了急性护理病房。分析受到斯普拉德利人种学的启发。
结果
发现了三个主题：1）预期与现实相遇；2）时间的价值和优先级排序；3）姑息治疗的内容和创建。
结论
与PCCT的预期相比，急性护理病房在价值观以及提供姑息治疗的方式上存在许多差异。教学方面的挑战众多，且提供姑息治疗需要付出努力。
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