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一项关于肿瘤护理人员对癌症患者自杀风险识别与管理的观点及需求的定性研究。

A qualitative study on the perspectives and needs of oncology nurses about recognition and management of suicide risk in cancer patients.

作者信息

Öztürk Sevda, Hiçdurmaz Duygu

机构信息

Department of Psychiatric Nursing, Hacettepe University Faculty of Nursing, Ankara, Turkey.

出版信息

J Clin Nurs. 2023 Mar;32(5-6):749-763. doi: 10.1111/jocn.16304. Epub 2022 Mar 27.

Abstract

AIMS

To determine the perspectives and needs of the oncology nurses in recognising and managing the risk of suicide in cancer patients.

BACKGROUND

Cancer patients are one of the groups with a high risk of suicide. The perspectives and needs of oncology nurses regarding their recognition and management of suicide risk in such patients need to be clarified.

DESIGN AND METHODS

This qualitative descriptive study used a sample of 33 oncology nurses that were sampled by maximum variation sampling from different oncology units and hospitals. Data were collected with in-depth interviews via a semi-structured interview form and analysed with content analysis. The COREQ guideline was followed for the reporting of the study.

RESULTS

Three main themes and eight subthemes were identified, namely 'An uncertain atmosphere: sensing the risk of suicide but not seeing the picture' (Subthemes: Inability to identify suicide risk, Unclear responsibilities and Distress as a result of uncertainty), 'Efforts to give meaning to and compensate losses of patients' (Subthemes: Attributions to cancer-related losses of patients and Interventions to alleviate distress related to loss) and 'Hindrances beyond the nurse' (Subthemes: Stigma towards psychosocial problems and getting help, Disagreement with the Physician and A lack of institutional culture on suicide prevention).

CONCLUSIONS

Our study revealed that oncology nurses have insufficient knowledge and skills and unclear roles in recognising and managing suicide risk. In addition, nurses have difficulty in helping patients due to the insufficient support of team members, stigmas of patients and their relatives towards getting help, patient workloads, and inadequate institutional support in risk management. Training programmes aiming to increase nurses' awareness, knowledge and skills should be developed and embedded into current in-service education programmes and undergraduate education curricula as part of professional improvement.

RELEVANCE TO CLINICAL PRACTICE

The results of the study can contribute to planning the content and scope of suicide prevention training peculiar to oncology nursing.

摘要

目的

确定肿瘤护理人员在识别和管理癌症患者自杀风险方面的观点和需求。

背景

癌症患者是自杀风险较高的群体之一。需要明确肿瘤护理人员在识别和管理此类患者自杀风险方面的观点和需求。

设计与方法

本定性描述性研究采用最大差异抽样法,从不同肿瘤科室和医院抽取了33名肿瘤护理人员作为样本。通过半结构化访谈形式进行深入访谈收集数据,并采用内容分析法进行分析。研究报告遵循COREQ指南。

结果

确定了三个主要主题和八个子主题,即“不确定的氛围:感知自杀风险但不明全貌”(子主题:无法识别自杀风险、责任不明确以及不确定性导致的困扰)、“努力赋予患者意义并弥补损失”(子主题:将患者的损失归因于癌症相关因素以及减轻与损失相关困扰的干预措施)和“护士之外的阻碍”(子主题:对心理社会问题和寻求帮助的污名化、与医生的分歧以及缺乏自杀预防的机构文化)。

结论

我们的研究表明,肿瘤护理人员在识别和管理自杀风险方面知识和技能不足,角色不明确。此外,由于团队成员支持不足、患者及其亲属对寻求帮助的污名化、患者工作量以及风险管理方面机构支持不足,护士在帮助患者时存在困难。应制定旨在提高护士意识、知识和技能的培训计划,并将其作为专业提升的一部分纳入当前的在职教育计划和本科教育课程。

与临床实践的相关性

该研究结果有助于规划肿瘤护理特有的自杀预防培训的内容和范围。

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