Jung Ha Na, Ju Hyeon Ok
Department of Nursing, Pusan National University Hospital, Busan, Korea.
Department of Nursing, Dong-A University, Busan, Korea.
J Hosp Palliat Care. 2021 Sep 1;24(3):165-173. doi: 10.14475/jhpc.2021.24.3.165.
This study aimed to compare the attitudes of nurses and physicians toward neonatal palliative care and identify the barriers to and facilitators of neonatal palliative care, with the goal of improving palliative care for infants in neonatal intensive care units (NICUs).
This cross-sectional study analyzed data from the NICUs of seven general hospitals with 112 nurses and 52 physicians participating. Data were collected using the Neonatal Palliative Care Attitude Scale questionnaire.
Only 12.5% of nurses and 11.5% of physicians reported that they had sufficient education in neonatal palliative care. In contrast, 89.3% of the nurses and 84.6% of the physicians reported that they needed further education. The common facilitators for both nurses and physicians were 1) agreement by all members of the department regarding the provision of palliative care and 2) informing parents about palliative care options. The common barriers for both nurses and physicians were 1) policies or guidelines supporting palliative care were not available, 2) counseling was not available, 3) technological imperatives, and 4) parental demands for continuing life support. Insufficient resources, staff, and time were also identified as barriers for nurses, whereas these were not identified as barriers for physicians.
It is necessary to develop hospital or national guidelines and educational programs on neonatal palliative care, and it is equally necessary to spread social awareness of the importance of neonatal palliative care.
本研究旨在比较护士和医生对新生儿姑息治疗的态度,并确定新生儿姑息治疗的障碍和促进因素,目标是改善新生儿重症监护病房(NICU)中婴儿的姑息治疗。
这项横断面研究分析了来自七家综合医院NICU的数据,112名护士和52名医生参与其中。使用新生儿姑息治疗态度量表问卷收集数据。
只有12.5%的护士和11.5%的医生表示他们接受过足够的新生儿姑息治疗教育。相比之下,89.3%的护士和84.6%的医生表示他们需要进一步的教育。护士和医生共同的促进因素是:1)科室所有成员就提供姑息治疗达成一致;2)向家长告知姑息治疗选项。护士和医生共同的障碍是:1)没有支持姑息治疗的政策或指南;2)没有咨询服务;3)技术需求;4)家长对持续生命支持的要求。资源、人员和时间不足也被确定为护士面临的障碍,而这些未被确定为医生面临的障碍。
有必要制定关于新生儿姑息治疗的医院或国家指南及教育项目,同样有必要提高社会对新生儿姑息治疗重要性的认识。