Ethics, Law and Humanities, Amsterdam, the Netherlands.
J Palliat Care. 2023 Jul;38(3):364-371. doi: 10.1177/08258597221098129. Epub 2022 May 25.
To identify moral challenges experienced by nurses and volunteers in palliative care. A qualitative hermeneutic research design was used. Interviews with nurses ( = 10) and volunteers ( = 4) working in palliative care, in-home care, and hospice setting. Participants were recruited through maximum variation, a purposive sampling technique. Transcriptions were analyzed using qualitative thematic content analysis and open coding. Two themes were identified, each with three subthemes: theme (A) Moral challenges regarding organizational and professional aspects contained the subthemes (1) dealing with protocols and regulations, (2) different professional perspectives on good care, and (3) limits of professionalism. Theme (B) Moral challenges regarding the patient and their family members contained the subthemes (1) dealing with the patient's wishes, (2) the patient's wish to die, and (3) dealing with family members. Nurses and volunteers working in palliative care are confronted with a wide range of moral challenges. Insight into 'real-world ethical challenges' of healthcare providers is important to provide adequate support to nurses and volunteers working in palliative care.
为了识别姑息治疗中护士和志愿者所经历的道德挑战。采用了定性解释学研究设计。对在姑息治疗、家庭护理和临终关怀环境中工作的护士（n=10）和志愿者（n=4）进行了访谈。参与者通过最大变异、目的抽样技术进行招募。使用定性主题内容分析和开放式编码对转录本进行分析。确定了两个主题，每个主题都有三个子主题：主题（A）关于组织和专业方面的道德挑战包含子主题（1）处理协议和规定，（2）对良好护理的不同专业观点，以及（3）职业精神的局限性。主题（B）关于患者及其家属的道德挑战包含子主题（1）处理患者的意愿，（2）患者的死亡意愿，以及（3）处理家属。在姑息治疗中工作的护士和志愿者面临着广泛的道德挑战。了解医疗保健提供者的“现实世界伦理挑战”对于为姑息治疗中的护士和志愿者提供充分的支持非常重要。
