从患者和医生的视角看关怀照护：一项访谈研究。
Compassionate care through the eyes of patients and physicians: An interview study.
机构信息
Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands.
Quality of Care, Amsterdam Public Health, Amsterdam, the Netherlands.
出版信息
PLoS One. 2024 Jul 10;19(7):e0305007. doi: 10.1371/journal.pone.0305007. eCollection 2024.
BACKGROUND
Although compassion is a crucial element of physicians' professional performance and high-quality care, research shows it often remains an unmet need of patients. Understanding patients' and physicians' perspectives on compassionate care may provide insights that can be used to foster physicians' ability to respond to patients' compassion needs. Therefore, this study aims to understand how both patients and physicians experience the concept and practice of compassionate care.
METHODS
We conducted semi-structured interviews with eight patients and ten resident physicians at a University Medical Center in the Netherlands. Using thematic analysis, we separately coded patient and resident transcripts to identify themes capturing their experiences of compassionate care. This study was part of a larger project to develop an educational intervention to improve compassion in residents.
RESULTS
For both patients and residents, we identified four themes encompassing compassionate care: being there, empathizing, actions to relieve patients' suffering, and connection. For residents, a fifth theme was professional fulfillment (resulting from compassionate care). Although patients and residents both emphasized the importance of compassionate care, patients did not always perceive the physician-patient encounter as compassionate. According to residents, high workloads and time pressures hindered their ability to provide compassionate care.
DISCUSSION AND CONCLUSION
Patients and residents have similar and varying understandings of compassionate care at the same time. Understanding these differences can aid compassion in medical practice. Based on the findings, three topics are suggested to improve compassion in residents: (1) train residents how to ask for patients' compassion needs, (2) address residents' limiting beliefs about the concept and practice of compassion, and (3) acknowledge the art and science of medicine cannot be separated.
背景
尽管同情是医生专业表现和高质量护理的关键要素，但研究表明，患者的同情需求往往仍未得到满足。了解患者和医生对同情护理的看法，可以提供可以用来培养医生回应患者同情需求的能力的见解。因此，本研究旨在了解患者和医生如何体验同情护理的概念和实践。
方法
我们在荷兰的一家大学医疗中心对 8 名患者和 10 名住院医师进行了半结构化访谈。我们使用主题分析分别对患者和住院医师的转录本进行编码，以确定捕捉他们对同情护理体验的主题。这项研究是一个旨在改善住院医师同情心的教育干预措施的更大项目的一部分。
结果
对于患者和住院医师来说，我们确定了包含同情护理的四个主题：在那里、同理心、减轻患者痛苦的行动和联系。对于住院医师来说，第五个主题是专业满足感（源于同情护理）。尽管患者和住院医师都强调同情护理的重要性，但患者并不总是认为医患接触是有同情心的。根据住院医师的说法，高工作量和时间压力阻碍了他们提供同情护理的能力。
讨论与结论
患者和住院医师对同一时间的同情护理有相似和不同的理解。了解这些差异可以帮助提高医疗实践中的同情心。基于这些发现，建议提高住院医师同情心的三个主题：（1）培训住院医师如何询问患者的同情需求，（2）解决住院医师对同情的概念和实践的限制信念，以及（3）承认医学的艺术和科学是不可分割的。
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