社会和医疗保健专业人员在姑息治疗中对临终关怀计划和文件记录的体验。
Social and healthcare professionals' experiences of end-of-life care planning and documentation in palliative care.
机构信息
Department of Nursing Science, University of Turku, Turku, Finland.
The Wellbeing Services County of Satakunta, Satasairaala Central Hospital Pori, Pori, Finland.
出版信息
Nurs Open. 2023 Sep;10(9):6445-6454. doi: 10.1002/nop2.1894. Epub 2023 Jun 19.
AIM
To explore social and healthcare professionals' experiences of end-of-life (EOL) care planning and documentation in palliative care.
DESIGN
A qualitative study with narrative methodology.
METHODS
A narrative method with interviews was used. Data were collected from purposively selected registered nurses (n = 18), practical nurses (n = 5), social workers (n = 5) and physicians (n = 5) working in palliative care unit in five hospitals in three hospital districts. Content analysis within narrative methodologies was undertaken.
RESULTS
Two main categories - patient-oriented EOL care planning and multi-professional EOL care planning documentation- were formed. Patient-oriented EOL care planning included treatment goals planning, disease treatment planning and EOL care setting planning. Multi-professional EOL care planning documentation included healthcare professionals' and social professionals' perspectives. Healthcare professionals' perspectives on EOL care planning documentation included benefits of structured documentation and poor support of electronic health record (EHR) for documentation. Social professionals' perspective on EOL care planning documentation included usefulness of multi-professional documentation and externality of social professionals in multi-professional documentation.
CONCLUSION
The results of this interdisciplinary study demonstrated a gap between what healthcare professionals consider important in Advance Care Planning (ACP), that is, proactive, patient-oriented and multi-professional EOL care planning and the ability to access and document this in a useful and accessible way in the EHR.
RELEVANCE TO CLINICAL PRACTICE
Knowledge of the patient-centered EOL care planning and multi-professional documentation processes and their challenges are prerequisites for documentation to be supported by technology.
REPORTING METHOD
The Consolidated Criteria for Reporting Qualitative Research checklist was followed.
PATIENT OR PUBLIC CONTRIBUTION
No patient or public contribution.
目的
探索社会和医疗保健专业人员在姑息治疗中对临终关怀计划和记录的体验。
设计
具有叙述方法的定性研究。
方法
采用叙述方法和访谈。从五个医院的姑息治疗病房中选择有目的的注册护士（n=18）、执业护士（n=5）、社会工作者（n=5）和医生（n=5）进行采访。采用叙述方法中的内容分析法进行数据分析。
结果
形成了两个主要类别——以患者为中心的临终关怀计划和多专业的临终关怀计划记录。以患者为中心的临终关怀计划包括治疗目标规划、疾病治疗规划和临终关怀环境规划。多专业的临终关怀计划记录包括医疗保健专业人员和社会专业人员的观点。医疗保健专业人员对临终关怀计划记录的观点包括结构化记录的好处和电子病历（EHR）对记录的支持不足。社会专业人员对临终关怀计划记录的观点包括多专业记录的有用性和社会专业人员在多专业记录中的外在性。
结论
这项跨学科研究的结果表明，医疗保健专业人员认为在预先护理计划（ACP）中重要的内容，即主动、以患者为中心和多专业的临终关怀计划，以及在 EHR 中以有用和可访问的方式访问和记录这些内容的能力之间存在差距。
临床相关性
了解以患者为中心的临终关怀计划和多专业记录过程及其挑战是技术支持记录的前提条件。
报告方法
遵循了定性研究的综合报告标准清单。
患者或公众贡献
没有患者或公众的贡献。
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