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护理学生在姑息治疗中关于沉默阴谋的知识和培训:参与式行动研究。

Knowledge and training among nursing students regarding the conspiracy of silence in palliative care: A participatory action research.

机构信息

Department of Nursing, University of Valencia, Menéndez Pelayo, 19, Valencia 46010, Spain.

出版信息

Nurse Educ Pract. 2024 Aug;79:104086. doi: 10.1016/j.nepr.2024.104086. Epub 2024 Aug 5.

Abstract

AIM

To develop and implement specific training based on the knowledge and management of conspiracy of silence among nursing students.

BACKGROUND

Conspiracy of silence refers to the concealment of information from a patient on the family's request, under the influence of a paternalistic culture that seeks to protect the patient.

DESIGN

Participatory action research.

METHODS

Was conducted in the following stages: reconnaissance (focus groups); planning, action and observation (theoretical sessions); and reflection (analysis of care plans). The focus group consisted of six fourth year and eight second-year students. The intervention was conducted with 42 s-year students and a total of 93 s-year students participated in the resolution of the clinical case. The study was conducted between October 2022 and June 2023 at the Faculty of Nursing, University of Valencia. For data analysis, the process described by Carrillo et al. (2011) was followed, involving coding and the creation of categories and subcategories.

RESULTS

The focus group deficiencies were detected in the students' learning of palliative care competence, breaking bad news and the conspiracy of silence (reconnaissance stage). Therefore, an intervention was conducted to reinforce these knowledge areas, specifically addressing the conspiracy of silence (planning, action and observation stages). The resolution of the case showed how students with training approached the situation more comprehensively, including the family and proposed activities that were consistent with managing the situation (reflection stage).

CONCLUSIONS

An active feedback process was successfully established, where the students' feedback helped create specific training on oncological palliative care and provided the students with tools to manage the conspiracy of silence. The results underscore the importance of providing students with training in palliative care and managing conspiracy of silence, through therapeutic communication training, active training or enhancing emotional intelligence. This training is essential for cultivating the attitudes and skills required to deliver high-quality palliative care.

摘要

目的

针对护理学生的沉默共谋知识和管理,制定并实施具体培训。

背景

沉默共谋是指在家长式文化的影响下,应家庭要求向患者隐瞒信息,旨在保护患者。

设计

参与行动研究。

方法

研究分以下阶段进行:侦察(焦点小组);规划、行动和观察(理论课程);以及反思(护理计划分析)。焦点小组由六名四年级学生和八名二年级学生组成。干预组由 42 名四年级学生和总共 93 名四年级学生参与解决临床案例。该研究于 2022 年 10 月至 2023 年 6 月在巴伦西亚大学护理学院进行。为了数据分析,遵循了 Carrillo 等人(2011 年)描述的过程,包括编码以及创建类别和子类别。

结果

在姑息治疗能力、坏消息告知和沉默共谋的学习中发现了焦点小组的缺陷(侦察阶段)。因此,进行了干预来强化这些知识领域,特别是针对沉默共谋(规划、行动和观察阶段)。案例的解决显示了经过培训的学生如何更全面地处理情况,包括家属和提出与管理情况一致的活动(反思阶段)。

结论

成功建立了一个积极的反馈过程,学生的反馈有助于制定针对肿瘤姑息治疗的具体培训,并为学生提供管理沉默共谋的工具。结果强调了为学生提供姑息治疗培训和管理沉默共谋的重要性,通过治疗性沟通培训、主动培训或增强情绪智力。这种培训对于培养提供高质量姑息治疗所需的态度和技能至关重要。

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