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资质与临终关怀教育对儿科肿瘤病房姑息治疗期间医护人员态度的影响——一项全国性调查

The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards-A National Survey.

作者信息

Salamon Eszter, Fodor Éva, Földesi Enikő, Hauser Peter, Kriván Gergely, Csanádi Krisztina, Garami Miklós, Kovacs Gabor, Csóka Monika, Tiszlavicz Lilla Györgyi, Kiss Csongor, Dergez Tímea, Ottóffy Gábor

机构信息

Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Pécs Medical School, József A. Street 7, 7623 Pécs, Hungary.

Institute of Behavioural Sciences, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary.

出版信息

Children (Basel). 2024 Feb 1;11(2):178. doi: 10.3390/children11020178.

Abstract

BACKGROUND

Our knowledge about the attitudes of healthcare staff to palliative care in pediatric oncology is scarce. We aimed to assess their perceptions of palliative care in Hungary and find answers to the question of how to provide good palliative care for children.

METHOD

Physicians ( = 30) and nurses ( = 43) working in the field of pediatric oncology (12 of them specialized in hospice care) were interviewed. Palliative care practice (communication, integration of palliative care, professionals' feelings and attitudes, and opportunities for improvement) was assessed by semi-structured interviews evaluated in a mixed quantitative and qualitative way by narrative categorical content analysis and thematic analysis.

RESULTS

All providers displayed high negative emotions, positive evaluations, and used many active verbs. Nurses showed higher levels of denial, more self-references, and were more likely to highlight loss. Physicians emphasized the importance of communication regarding adequate or inadequate palliative care. Hospice specialists showed a higher passive verb rate, a lower self-reference, a lower need for psychological support, and a greater emphasis on teamwork and professional aspects.

CONCLUSION

Our results show that nurses are more emotionally stressed than doctors in palliative care in pediatric oncology. To our knowledge, a study comparing doctors and nurses in this field has yet to be carried out. Our results suggest that pediatric oncological staff can positively evaluate a child's palliative care despite the emotional strain. Regarding hospices, professional practice in palliative care may be a protective factor in reducing emotional distress and achieving professional well-being.

摘要

背景

我们对儿科肿瘤医护人员对姑息治疗态度的了解很少。我们旨在评估他们对匈牙利姑息治疗的看法,并找到如何为儿童提供优质姑息治疗这一问题的答案。

方法

对从事儿科肿瘤领域工作的医生(n = 30)和护士(n = 43)进行了访谈(其中12人专门从事临终关怀)。通过半结构化访谈评估姑息治疗实践(沟通、姑息治疗的整合、专业人员的感受和态度以及改进机会),并采用叙事分类内容分析和主题分析以混合定量和定性的方式进行评估。

结果

所有提供者都表现出高度的负面情绪、积极评价,并使用了许多主动动词。护士表现出更高程度的否认、更多的自我提及,并且更有可能强调损失。医生强调了关于姑息治疗是否充分的沟通的重要性。临终关怀专家表现出更高的被动动词使用率、更低的自我提及、更低的心理支持需求,并且更强调团队合作和专业方面。

结论

我们的结果表明,在儿科肿瘤姑息治疗中,护士比医生承受更多的情绪压力。据我们所知,尚未开展过该领域医生与护士对比的研究。我们的结果表明,尽管存在情绪压力,儿科肿瘤医护人员仍能对儿童的姑息治疗给予积极评价。关于临终关怀机构,姑息治疗中的专业实践可能是减轻情绪困扰并实现职业幸福感的一个保护因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d4d/10886866/b1b317c5819f/children-11-00178-g002.jpg

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