Saint Kirin, Ehrlinger Rachel, Gilliland Jaime, Barton Michael F, Xu Amy J, Santos Patricia Mae G, Yerramilli Divya
Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois.
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
Adv Radiat Oncol. 2024 Aug 26;9(11):101617. doi: 10.1016/j.adro.2024.101617. eCollection 2024 Nov.
While there are many benefits to radiation oncology services, there can be emotional burdens in the care of patients with advanced cancer. Burnout is a prevalent problem in oncology. Existing literature suggests refocusing attention on providers' sense of purpose to protect against burnout. "Sacred moments" are moments of deep interconnection between people with accompanying spiritual emotions such as awe, joy, and gratitude. These moments naturally occur in health care settings, offering potential benefits to both patient and provider. Little is known about the prevalence and impact of sacred moments among health care workers in a radiation oncology setting.
We conducted an exploratory qualitative study of 13 semi-structured interviews among physicians, registered nurses, and advanced practice providers of a radiation oncology consult service at a large National Cancer Institute-designated cancer center between March and May 2023. Interviews were recorded, transcribed, and analyzed to identify key themes. Data were systematically coded and analyzed in NVivo software and organized into a codebook organized by domains and themes.
Of the 13 health care workers interviewed, 12 interviewees reported experiencing at least one sacred moment during their clinical careers. None of the interviewees were initially familiar with the term; however, all understood the concept once explained. Interview findings were organized into four domains: (1) common elements, (2) impact, (3) barriers, and (4) provider reactions. Common elements included a moment of deep interconnection between provider and patient, often involving end-of-life patients. The impact of these moments was most commonly described as an increased sense of purpose in their role. Lack of time with patients was the most common barrier.
Sacred moments are commonly experienced by health care workers in a radiation oncology consult service. They helped to humanize the patient, buffer against provider burnout, and increase a sense of purpose and job satisfaction.
虽然放射肿瘤学服务有诸多益处，但在治疗晚期癌症患者时可能会带来情感负担。职业倦怠是肿瘤学领域普遍存在的问题。现有文献表明，应重新将注意力集中在医护人员的使命感上，以预防职业倦怠。“神圣时刻”是人与人之间深度联系的时刻，伴随着敬畏、喜悦和感激等精神情感。这些时刻在医疗环境中自然发生，对患者和医护人员都可能带来潜在益处。对于放射肿瘤学环境中医护人员之间神圣时刻的发生率和影响，我们知之甚少。
2023年3月至5月，我们在一家大型国立癌症研究所指定的癌症中心，对放射肿瘤学咨询服务的医生、注册护士和高级执业人员进行了13次半结构化访谈，开展了一项探索性定性研究。访谈进行了录音、转录和分析，以确定关键主题。数据在NVivo软件中进行系统编码和分析，并整理成一个按领域和主题组织的编码手册。
在接受访谈的13名医护人员中，12名受访者报告在其临床职业生涯中至少经历过一次神圣时刻。所有受访者最初都不熟悉这个术语；然而，一经解释，他们都理解了这个概念。访谈结果分为四个领域：（1）共同要素，（2）影响，（3）障碍，（4）医护人员的反应。共同要素包括医护人员与患者之间深度联系的时刻，通常涉及临终患者。这些时刻的影响最常被描述为角色使命感增强。与患者相处时间不足是最常见的障碍。
放射肿瘤学咨询服务中的医护人员普遍经历过神圣时刻。它们有助于使患者更具人性，缓解医护人员的职业倦怠，并增强使命感和工作满意度。
