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高质量以患者为中心的姑息治疗:多专业团队成员对社会工作者角色和贡献的看法。

High-quality patient-centered palliative care: interprofessional team members' perceptions of social workers' roles and contribution.

机构信息

School of Social Work, Boston University, Boston, USA.

出版信息

J Interprof Care. 2024 Jan 2;38(1):1-9. doi: 10.1080/13561820.2023.2238783. Epub 2023 Aug 1.

Abstract

A core tenet of interprofessional collaborative practice (IPCP) is that efficient and effective teams are critical for the delivery of high-quality, patient-centered care. Although palliative care has a history of excellent care, increasing demands and larger patient loads are challenging teams to adapt and strengthen team functioning in hospital settings. The purpose of this qualitative study was to better understand the IPCP contributions of advanced palliative social workers (PSWs) through the eyes of their colleagues. Twenty-four interprofessional palliative care (IPPC) team members from other professions (i.e. nurse practitioners, physicians, physician assistants) from 16 hospitals across the U.S. participated in 20-minute semi-structured interviews. The Patient-Centered Clinical Method (PCCM) was used as a conceptual model to aid in the interpretation of the data. This model illuminated the centrality of PSWs' role in building and sustaining a therapeutic alliance between the patient and the IPPC team, through assessing and promoting care that centers the patient's experience with illness, creating space to initiate, process and revisit difficult healthcare conversations and helping to modulate the pace and intensity of emotionally laden discussions. PSWs also support the therapeutic relationship with the IPPC team by providing continuity and connection across and during the hospital experience and supporting the well-being of the IPPC team. This study offers novel insights into how PSWs contribute to patient-centered IPPC and furthers the articulation of the role of PSWs in hospital settings.

摘要

跨专业协作实践(IPCP)的核心原则之一是,高效、有效的团队对于提供高质量、以患者为中心的护理至关重要。尽管姑息治疗有着出色护理的历史,但不断增加的需求和更大的患者量正挑战着团队在医院环境中适应和加强团队功能的能力。本定性研究的目的是通过同事的视角更好地了解高级姑息治疗社会工作者(PSWs)对跨专业姑息治疗(IPPC)团队的贡献。来自美国 16 家医院的 24 名其他专业(即护士从业者、医生、医师助理)的跨专业姑息治疗(IPPC)团队成员参与了 20 分钟的半结构化访谈。采用以患者为中心的临床方法(PCCM)作为概念模型来辅助解释数据。该模型阐明了 PSWs 在建立和维持患者与 IPPC 团队之间的治疗联盟方面的核心作用,通过评估和促进以患者的疾病体验为中心的护理,为发起、处理和重新审视困难的医疗保健对话创造空间,并帮助调节充满情感的讨论的节奏和强度。PSWs 还通过在医院体验期间和期间提供跨团队的连续性和联系,以及支持 IPPC 团队的福祉,来支持与 IPPC 团队的治疗关系。这项研究提供了有关 PSWs 如何为以患者为中心的 IPCP 做出贡献的新见解,并进一步阐明了 PSWs 在医院环境中的角色。

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