Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
Mental Health and Addictions, Division of Psychiatry, Te Whatu Ora Health NZ Counties Manukau, Auckland, New Zealand.
BMJ Open. 2023 Apr 5;13(4):e064144. doi: 10.1136/bmjopen-2022-064144.
Schwartz Rounds are forums that enable healthcare staff to reflect on emotional and social dimensions of their work. In this study, we aimed to explore the experiences of Schwartz Rounds on emotional aspects of care and practice within a clinical environment.
Using qualitative methods, we interviewed participants individually and in focus groups. Interviews were recorded, transcribed and analysed by thematic analysis.
The study was based at a public health service Te Whatu Ora Counties Manukau in Auckland, New Zealand's largest, most ethnically diverse population.
Participants were panellists who took part in successive Schwartz Rounds over a 10-month period. There were 17 participants with a range of experience (1-30 years) and occupations including clinical, allied, technical and administrative staff from medical specialties of plastic surgery, pain services, emergency medicine, intensive care, organ donation services, COVID-19 response and palliative care services.
Three themes were identified: the need for emotional processing, valuing guided reflection and realising our humanity. The third theme 'realising our humanity' comprised altruism, connection and compassion. Schwartz Rounds provided staff with clear benefits: emotionally resonant experiences within an environment of psychological safety and connection to the wider organisation. The daunting nature of emotional disclosure was mitigated by a supportive audience.
There is an organisational imperative to ensure that staff have opportunities to process intense emotions associated with healthcare work. Schwartz Rounds are one means to attend to the emotional welfare of healthcare staff, enabling them to gain different perspectives in the care of their patients and colleagues within system constraints.
施瓦茨轮是一个使医疗保健人员能够反思其工作的情感和社会层面的论坛。在这项研究中,我们旨在探讨在临床环境中施瓦茨轮对护理和实践的情感方面的经验。
使用定性方法,我们对参与者进行了个人和焦点小组访谈。访谈被录音、转录并通过主题分析进行分析。
这项研究是在新西兰最大、种族最多样化的奥克兰人口的公共卫生服务机构特瓦胡拉·奥罗阿·克劳迪斯·马努考进行的。
参与者是在 10 个月的时间里参加连续施瓦茨轮的小组成员。参与者的经验(1-30 年)和职业范围广泛,包括来自整形手术、疼痛服务、急诊医学、重症监护、器官捐赠服务、COVID-19 反应和姑息治疗服务等医学专业的临床、联合、技术和行政人员。
确定了三个主题:情感处理的必要性、重视引导性反思和认识到我们的人性。第三个主题“认识到我们的人性”包括利他主义、联系和同情心。施瓦茨轮为员工提供了明确的好处:在心理安全和与更广泛组织联系的环境中,产生情感共鸣的体验。通过支持性的听众,减轻了情感披露的艰巨性。
组织有必要确保员工有机会处理与医疗保健工作相关的强烈情绪。施瓦茨轮是关注医疗保健人员情感福利的一种手段,使他们能够在系统限制内为患者和同事提供不同的护理视角。