心力衰竭护理中预后和临终关怀的沟通以及使用心力衰竭问题提示清单的经验。
Communication about Prognosis and End-of-Life in Heart Failure Care and Experiences Using a Heart Failure Question Prompt List.
机构信息
Department of Health Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden.
Department of Nursing, School of Health and Welfare, Jönköping University, 551 11 Jönköping, Sweden.
出版信息
Int J Environ Res Public Health. 2022 Apr 15;19(8):4841. doi: 10.3390/ijerph19084841.
BACKGROUND
To further advance the use of a heart-failure-specific question prompt list (HF-QPL) for communication about prognosis and end-of-life care, knowledge about such communication and the perceptions and experiences of professionals is needed.
OBJECTIVES
- to describe health care professionals' perceptions of communication about prognosis and end-of-life in heart failure (HF) care, and 2. to describe their experiences of using a HF-QPL.
DESIGN
A qualitative design that analyzed material from written assignments of nurses and physicians who were using a HF-QPL while participating in a communication course.
METHODS
Fifteen health care professionals from different regions in the south of Sweden were included. The data were collected from course assignments on 1. their reflection on the suitable timepoint for talking about prognosis for the first time, 2. their reflection on the HF-QPL, and 3. their experiences of using the HF-QPL in clinical practice. Data were analyzed using thematic analysis.
RESULTS
Five overarching themes were identified. The first theme was awareness of professional role responsibilities that described the recognition of different responsibilities in these conversations within the HF team. The second theme described the importance of being optimally prepared, and the third that confidence and skills are required to use the HF-QPL. The fourth theme described the HF-QPL as a bridge in the communication between professionals, patients, and family members. The fifth theme identified challenges using the HF-QPL in HF care.
CONCLUSIONS
Using a HF-QPL in HF care has the potential to start conversation and facilitate discussion about the HF trajectory.
背景
为了进一步推进使用心力衰竭特定问题提示清单（HF-QPL）进行预后和临终关怀沟通，需要了解此类沟通以及专业人员的看法和经验。
目的
- 描述医疗保健专业人员对心力衰竭（HF）护理中预后和临终关怀沟通的看法，2. 描述他们使用 HF-QPL 的经验。
设计
对参加沟通课程的护士和医生使用 HF-QPL 时的书面作业中的材料进行分析的定性设计。
方法
从瑞典南部不同地区招募了 15 名医疗保健专业人员。数据来自课程作业，内容涉及：1. 他们对首次讨论预后的适当时间点的反思，2. 对 HF-QPL 的反思，3. 在临床实践中使用 HF-QPL 的经验。使用主题分析对数据进行分析。
结果
确定了五个总体主题。第一个主题是对专业角色责任的认识，描述了 HF 团队内这些对话中不同责任的认识。第二个主题描述了最佳准备的重要性，第三个主题描述了使用 HF-QPL 需要信心和技能。第四个主题将 HF-QPL 描述为专业人员、患者和家属之间沟通的桥梁。第五个主题确定了在 HF 护理中使用 HF-QPL 面临的挑战。
结论
在 HF 护理中使用 HF-QPL 有可能启动对话并促进 HF 轨迹的讨论。
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