Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
BMC Palliat Care. 2024 Sep 28;23(1):231. doi: 10.1186/s12904-024-01562-9.
Journeying with patients throughout their cancer trajectory and caring for them at the end of life can lead to emotional and moral distress in oncologists, negatively impacting their personal and professional identities. A better understanding of how transitions in care goals affect oncologists can shed light on the challenges faced and the support required. This study explored the impact of care transitions on oncologists' professional identity formation (PIF).
From September to December 2023, semi-structured interviews were conducted with oncologists in a palliative care center in Singapore. The Ring Theory of Personhood (RToP) was used as a framework to capture the effects of experiences with patients transitioning from curative to palliative care on the oncologists' sense of self and identity. Data were analyzed using both inductive and deductive qualitative analysis.
Participants included six female and six male physicians, aged 30 to 53 years (mean 38 years), with an average of 9.75 years of experience as oncologists. The main domains identified were 1) challenges faced in transitioning patients to palliative care, 2) the impact of dealing with dying patients on oncologists, and 3) coping mechanisms.
Oncologists experience self-doubt and moral distress as they manage transitions in care. The PIF of oncologists can be supported through reflection and introspection, peer support, and interventions to promote self-care - ultimately enabling them to make meaning of their experiences, renew family ties, and reaffirm their commitment to the profession.
在癌症患者的整个病程中陪伴他们，并在生命末期照顾他们，这可能会导致肿瘤学家产生情绪和道德困扰，对他们的个人和职业身份产生负面影响。更好地了解照顾目标的转变如何影响肿瘤学家，可以揭示所面临的挑战和所需的支持。本研究探讨了照顾转变对肿瘤学家职业身份形成（PIF）的影响。
2023 年 9 月至 12 月，在新加坡的一家姑息治疗中心对肿瘤学家进行了半结构化访谈。使用人格的环形理论（RToP）作为框架，捕捉肿瘤学家在经历从治愈性护理向姑息性护理转变的患者时，对自我和身份的感知的影响。使用归纳和演绎定性分析对数据进行分析。
参与者包括 6 名女性和 6 名男性医生，年龄在 30 至 53 岁之间（平均 38 岁），作为肿瘤学家的平均经验为 9.75 年。确定的主要领域包括 1）将患者过渡到姑息治疗所面临的挑战，2）处理临终患者对肿瘤学家的影响，3）应对机制。
肿瘤学家在管理护理转变时会感到自我怀疑和道德困扰。通过反思和内省、同行支持以及促进自我保健的干预措施，可以支持肿瘤学家的 PIF——最终使他们能够理解自己的经验，重新建立家庭联系，并重新确认对职业的承诺。
