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一项多方法准实验研究,旨在评估接受叙事医学干预的护士、助产士和相关医疗保健专业人员的同情满足/疲劳感。

A multi-method quasi-experimental study to assess compassion satisfaction/fatigue in nurses, midwives and allied health professionals receiving a narrative medicine intervention.

机构信息

Healthcare Professions Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.

Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.

出版信息

J Adv Nurs. 2023 Sep;79(9):3595-3608. doi: 10.1111/jan.15686. Epub 2023 Apr 23.

Abstract

AIMS

To: (1) measure the impact of a narrative medicine intervention on compassion fatigue and compassion satisfaction of nurses, midwives and allied health professionals; (2) explore participants' working experiences and (3) their impressions of the intervention.

DESIGN

Multi-methods, quasi-experimental before-after intervention design.

METHODS

The intervention consisted of 20 narrative medicine sessions (60 h). Healthcare providers (N = 48) from a mother-and-child hospital in Italy completed the 'Professional quality of life' questionnaire before and after the intervention (January 2020-April 2021). Baseline scores served as internal controls. Open-ended questions explored participants' touching experiences at work and their evaluation of the intervention. A thematic content analysis was performed. Reporting followed the TREND and SRQR guidelines.

RESULTS

The differences before-after intervention in compassion satisfaction or fatigue scores were not statistically significant. Three themes emerged from participants' touching experiences: "Witnessing death and sufferance"; "Witnessing violence" and "Organizational stressors during COVID-19". A statistically significantly higher median score for post-intervention compassion satisfaction was found among participants who reported at least one touching experience compared to those who had no touching experience. Four themes emerged from the reported strengths of the program: "Learning to exteriorize feelings"; "Team building"; "Useful to rework personal/professional journey" and "Develops professional empowerment". Two themes emerged from reported weaknesses: "Programme organization" and "Participants' difficulties in sharing experiences".

CONCLUSION

A time-limited narrative medicine intervention is not sufficient to produce significant changes in satisfaction or compassion fatigue, especially if implemented during a pandemic. However, such an intervention holds promise for supporting nurses and midwives' professional empowerment and promoting continuity of compassionate care.

IMPACT

For those at risk of compassion fatigue, policymakers need to invest in training in narrative medicine, which promotes team building, and employee well-being and thus favours compassionate care. Such programmes should be offered to undergraduate students to nurture compassion and attention to self.

PATIENT OR PUBLIC CONTRIBUTION

Does not apply as the study only includes health care providers.

摘要

目的

(1)测量叙事医学干预对护士、助产士和辅助卫生专业人员的同情疲劳和同情满足感的影响;(2)探索参与者的工作经验;(3)了解他们对干预的印象。

设计

多方法、准实验前后干预设计。

方法

干预措施包括 20 次叙事医学课程(60 小时)。意大利一家母婴医院的医疗保健提供者(N=48)在干预前后(2020 年 1 月至 2021 年 4 月)完成了“专业生活质量”问卷。基线分数作为内部对照。开放性问题探讨了参与者在工作中的感人经历和他们对干预的评价。采用主题内容分析法。报告遵循 TREND 和 SRQR 指南。

结果

干预前后同情满足感或疲劳感评分的差异无统计学意义。参与者感人经历中出现了三个主题:“见证死亡和痛苦”;“见证暴力”和“COVID-19 期间的组织压力”。与没有感人经历的参与者相比,报告至少有一次感人经历的参与者的干预后同情满足感评分中位数显著较高。报告的方案优势出现了四个主题:“学会外化感受”;“团队建设”;“对个人/职业发展有用”和“发展专业授权”。报告的弱点出现了两个主题:“方案组织”和“参与者分享经验的困难”。

结论

限时叙事医学干预不足以显著改变满意度或同情疲劳感,尤其是在大流行期间实施时。然而,这种干预有可能支持护士和助产士的专业赋权,并促进有同情心的护理的连续性。

影响

对于那些有同情疲劳风险的人,政策制定者需要投资于叙事医学培训,这可以促进团队建设、员工福利,从而有利于有同情心的护理。应向本科生提供此类方案,以培养同情心和对自身的关注。

患者或公众贡献

不适用,因为该研究仅包括医疗保健提供者。

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