Buonaccorso Loredana, Alquati Sara, Ghirotto Luca, Annini Alice, Tanzi Silvia
Scientific Directorate, Azienda USL-IRCSS di Reggio Emilia, Reggio Emilia, Italy.
Palliative Care Unit, Azienda USL-IRCSS di Reggio Emilia, Reggio Emilia, Italy.
Front Psychol. 2022 Jul 25;13:859775. doi: 10.3389/fpsyg.2022.859775. eCollection 2022.
Dignity therapy (DT) is brief psychotherapy targeting psychological and existential suffering among patients with a life-limiting illness. Studies have been conducted on the use of DT by healthcare professionals. In Italy, the current legislation defines that any form of psychotherapy may be performed exclusively by psychotherapists. Consequently, this intervention is unlikely to be used by other healthcare professionals. Herein, we will describe a training on DT not as a psychotherapy intervention but as a narrative intervention for non-psychotherapists health care professionals. Finally, we will explore the potential enablers/barriers as experienced by palliative care physicians and nurses.
The study was conducted in the Psycho-Oncology Unit within the Cancer Research Hospital of Reggio Emilia (Italy). It consisted of an exploratory qualitative case study. Data were collected employing observations and interview data and thematically analyzed.
The training was attended by six physicians and ten nurses and took place during two-afternoon sessions for 10 h. Two participants put their training into practice and administered DT under the supervision of a psychotherapist. Data analysis highlighted five overarching themes relating to the training experience and direct use of DT, namely, (i) time required, (ii) psychological skills, (iii) patient's disease awareness, (iv) patient's life history, and (v) distinguishing DT from Advance Care Planning.
Palliative care professionals found DT to be a valuable non-pharmacological hospital-based intervention to address the person beyond the patient and his clinical conditions. In our experience, considering that in Italy, psychotherapy is an intervention that psychotherapists can only perform, it can help organize different training on DT for psychotherapists and other healthcare professionals.
尊严疗法(DT)是一种针对患有生命受限疾病的患者的心理和存在性痛苦的简短心理治疗方法。已经有关于医疗保健专业人员使用DT的研究。在意大利,现行法律规定任何形式的心理治疗只能由心理治疗师进行。因此,其他医疗保健专业人员不太可能使用这种干预措施。在此,我们将描述一项关于DT的培训,不是将其作为一种心理治疗干预,而是作为一种针对非心理治疗师的医疗保健专业人员的叙事干预。最后,我们将探讨姑息治疗医生和护士所经历的潜在促进因素/障碍。
该研究在意大利雷焦艾米利亚癌症研究医院的心理肿瘤科进行。它包括一项探索性定性案例研究。通过观察和访谈数据收集数据并进行主题分析。
六名医生和十名护士参加了培训,培训在两个下午进行,共10小时。两名参与者将他们的培训付诸实践,并在心理治疗师的监督下实施了DT。数据分析突出了与培训经历和DT的直接使用相关的五个总体主题,即:(i)所需时间,(ii)心理技能,(iii)患者的疾病意识,(iv)患者的生活史,以及(v)将DT与预先护理计划区分开来。
姑息治疗专业人员发现DT是一种有价值的基于医院的非药物干预措施,可超越患者及其临床状况关注患者本人。根据我们的经验,考虑到在意大利心理治疗是心理治疗师才能进行的干预,它有助于为心理治疗师和其他医疗保健专业人员组织不同的DT培训。