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促进计划性居家死亡:一项关于家庭护理护士对促进因素和障碍体验的定性研究。

Facilitating planned home death: A qualitative study on home care nurses' experiences of enablers and barriers.

作者信息

Sørstrøm Anne Kristine, Ludvigsen Mette Spliid, Kymre Ingjerd Gåre

机构信息

Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.

Department of Clinical Medicine - Randers Regional Hospital, Aarhus University, Aarhus, Denmark.

出版信息

J Adv Nurs. 2025 Jan;81(1):340-352. doi: 10.1111/jan.16171. Epub 2024 Mar 21.

Abstract

AIM

The aim of this study was to explore home care nurses' experience of enablers and barriers for planned home death in municipal health care.

DESIGN

A focused ethnography.

METHODS

This qualitative study collected data from 20 semi-structured interviews of home care nurses and 8.5 h of participant observations. Data was analyzed using thematic analysis.

RESULTS

The findings in our study show that home care nurses consider supportive cultures, a commitment to safety and continuity when facilitating planned home deaths and family rotations to be enablers for planned home deaths. Barriers to planned home deaths involve a lack of palliative experience affecting confidence, shortages of nurses and medical supplies and night shift challenges.

CONCLUSION

This study underscores the need for supportive organizational cultures, ongoing education and improved communication and staffing policies to enhance the quality of care and the experiences of patients and home care nurses, especially in the context of planned home deaths.

IMPACT

The study adds knowledge to the evidence base of the practice of facilitating planned home deaths. The findings of the study could offer valuable insights for shaping future policies or devising effective implementation strategies.

REPORTING METHOD

Adherence to the COREQ guidelines for reporting qualitative research was maintained.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution. WHAT DOES THIS ARTICLE CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Identified enablers and barriers provide a new perspective, contributing to a comprehensive understanding of planning home deaths. The study emphasizes supportive cultures, safety commitment and family rotations as crucial for planned home deaths, guiding healthcare professionals to adopt best practices and enhance palliative care quality.

摘要

目的

本研究旨在探讨家庭护理护士在市政医疗保健中对计划在家中死亡的促进因素和障碍的体验。

设计

一项聚焦民族志研究。

方法

这项定性研究通过对家庭护理护士进行20次半结构化访谈以及8.5小时的参与观察来收集数据。使用主题分析法对数据进行分析。

结果

我们的研究结果表明,家庭护理护士认为支持性文化、在促进计划在家中死亡和家庭轮值时对安全及连续性的承诺是计划在家中死亡的促进因素。计划在家中死亡的障碍包括缺乏影响信心的姑息治疗经验、护士和医疗用品短缺以及夜班挑战。

结论

本研究强调需要支持性的组织文化、持续教育以及改进沟通和人员配置政策,以提高护理质量以及患者和家庭护理护士的体验,尤其是在计划在家中死亡的情况下。

影响

该研究为促进计划在家中死亡的实践证据库增添了知识。研究结果可为制定未来政策或设计有效的实施策略提供有价值的见解。

报告方法

遵循COREQ定性研究报告指南。

患者或公众贡献

无患者或公众参与。本文对更广泛的全球临床社区有何贡献?:确定的促进因素和障碍提供了一个新视角,有助于全面理解计划在家中死亡。该研究强调支持性文化、安全承诺和家庭轮值对计划在家中死亡至关重要,指导医疗保健专业人员采用最佳实践并提高姑息治疗质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71d9/11638527/6506a03d0210/JAN-81-340-g001.jpg

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