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姑息治疗护士面临的伦理困境:系统评价

Ethical dilemmas for palliative care nurses: systematic review.

作者信息

Geng Shuwan, Zhang Lei, Zhang Quan, Wu Yijin

机构信息

Center for Geriatric Healhcare Services and Health Education, Qufu Normal University, Qufu, Shandong, China.

Department of Physical Examination, Rizhao People's Hospital, Rizhao, Shandong, China.

出版信息

BMJ Support Palliat Care. 2024 Mar 27. doi: 10.1136/spcare-2023-004742.

Abstract

BACKGROUND

Nurses play a unique and critical role in palliative care, and it is noteworthy that nurses often encounter ethical dilemmas in this field.

OBJECTIVE

This review aims to conduct a summarised synthesis of the latest research on the ethical considerations nurses faced in palliative care.

METHODS

We conducted a rigorous systematic review of relevant existing studies published in high-quality English peer-reviewed journals from January 2017 to July 2023. We identified a total of 4492 articles (1029 in Web of Science, 1570 in PubMed and 1893 in Science Direct). Out of these, only 13 studies met the inclusion criteria.

RESULTS

Following the thematic analysis, the ethical considerations reported in these 13 studies were grouped into three main themes and four subthemes: ethical issues in communication (ethical issues in communication with patients, ethical issues in communication with families), ethical issues in decision-making (autonomy, dignity) and moral distress in palliative care.

CONCLUSION

This study elaborated on the ethical challenges faced by nurses in their communication with patients and families as well as decision-making and analysed the causes and effects of ethical distress, hoping to give a hand to ethical issues for nurses' work in palliative care.

摘要

背景

护士在姑息治疗中发挥着独特且关键的作用,值得注意的是,护士在该领域经常会遇到伦理困境。

目的

本综述旨在对护士在姑息治疗中面临的伦理考量的最新研究进行总结性综合分析。

方法

我们对2017年1月至2023年7月在高质量英文同行评审期刊上发表的相关现有研究进行了严格的系统综述。我们共识别出4492篇文章(科学网1029篇、PubMed 1570篇、科学Direct 1893篇)。其中,仅有13项研究符合纳入标准。

结果

经过主题分析,这13项研究中报告的伦理考量被归纳为三个主要主题和四个子主题:沟通中的伦理问题(与患者沟通中的伦理问题、与家属沟通中的伦理问题)、决策中的伦理问题(自主性、尊严)以及姑息治疗中的道德困扰。

结论

本研究阐述了护士在与患者及家属沟通以及决策过程中面临的伦理挑战,并分析了伦理困扰的成因及影响,希望能为护士在姑息治疗工作中的伦理问题提供帮助。

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