School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Nursing, Qilu Hospital of Shandong University, Jinan, Shandong, China.
BMC Palliat Care. 2022 Feb 1;21(1):14. doi: 10.1186/s12904-022-00905-8.
Hospital facilities in China are experiencing increased strain on existing systems and medical resources, necessitating the use of home-based hospice and palliative care (HBHPC). HBHPC primarily relies on community nurses and related medical personnel. Understanding the challenges that community nurses face when providing this form of care is urgently needed to optimize the design and delivery of HBHPC. Our study aimed to gain insight into community nurses' challenges when providing HBHPC for patients.
We performed a descriptive qualitative study using a phenomenology approach. Purposive sampling was used to recruit 13 nurses from two community health service centers in Jinan, Shandong Province, China. A thematic analysis was applied to identify themes from the transcribed data.
Three major themes emerged: 1) Community nurses' inadequate self-preparation for providing HBHPC; 2) Patients and their families' non-collaboration in HBHPC; 3) Community health service career disadvantages. Many negative experiences can be attributed to institutional barriers.
Community nurses faced multifaceted challenges in home care settings. This study could provide a framework for guiding the improvement of interventional variables in the provision of HBHPC. Future research should involve developing effective methods of improving community nurses' job motivation and community health service institutions' incentive systems, as well as increasing advocacy around HBHPC.
中国的医院设施面临着现有系统和医疗资源的压力增加，需要采用家庭为基础的临终关怀和姑息治疗（HBHPC）。HBHPC 主要依赖社区护士和相关医疗人员。了解社区护士在提供这种护理形式时面临的挑战，对于优化 HBHPC 的设计和实施至关重要。我们的研究旨在深入了解社区护士在为患者提供 HBHPC 时所面临的挑战。
我们采用描述性定性研究方法，采用现象学方法。采用目的抽样法，从中国山东省济南市的两个社区卫生服务中心招募了 13 名护士。对转录数据进行主题分析，以确定主题。
出现了三个主要主题：1）社区护士在提供 HBHPC 方面的自我准备不足；2）患者及其家属在 HBHPC 中的不合作；3）社区卫生服务职业劣势。许多负面经验可以归因于制度障碍。
社区护士在家庭护理环境中面临多方面的挑战。本研究可以为指导改善 HBHPC 提供的干预变量提供框架。未来的研究应涉及开发有效方法来提高社区护士的工作动力和社区卫生服务机构的激励制度，并增加对 HBHPC 的宣传。
