Inner Mongolia Medical University, Hohhot, China; School of Nursing, Peking University, Beijing, China.
Department of Rheumatology and Immunology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China; Inner Mongolia Key Laboratory for Pathogenesis and Diagnosis of Rheumatic and Autoimmune Diseases, Hohhot, China.
Geriatr Nurs. 2024 Sep-Oct;59:557-563. doi: 10.1016/j.gerinurse.2024.07.030. Epub 2024 Aug 17.
The viability of advance care planning (ACP) in cultures where discussing future desires is taboo is unclear, it is essential to examine the challenges faced by Chinese nurses lacking legal protection for ACP.
To comprehend Chinese oncology nurses' perceptions of serious illness conversation and ACP, and identify barriers to engagement.
A qualitative descriptive exploratory study involving semi-structured interviews with 13 experienced oncology nurses, analyzed using thematic analysis and critical incident technique, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.
Four themes emerged: Inadequate Competence Causes Patient Harm, Cultural Influences to Patient Autonomy, Psychological Tolerance Neglects Best Interests, and Systemic and Legal Uncertainties Impact Patient Rights.
Policy changes supporting nurses in ACP implementation, a 'whole-system strategic approach' involving legislative changes, organizational support, and public awareness are crucial for optimizing ACP and meeting diverse patient needs.
在忌讳讨论未来愿望的文化中，预先医疗照护计划（ACP）的可行性尚不清楚，因此有必要研究缺乏 ACP 法律保护的中国护士所面临的挑战。
了解中国肿瘤护士对重病沟通和 ACP 的看法，并确定参与的障碍。
采用定性描述性探索性研究，对 13 名有经验的肿瘤护士进行半结构式访谈，采用主题分析和关键事件技术进行分析，遵循《定性研究报告的统一标准》（COREQ）指南。
出现了四个主题：能力不足导致患者伤害、文化对患者自主权的影响、心理容忍忽视最佳利益、系统和法律不确定性影响患者权利。
支持护士实施 ACP 的政策变化，包括立法改革、组织支持和公众意识的“全系统战略方法”，对于优化 ACP 和满足不同患者的需求至关重要。
