Sabar Ron, Halevi Hochwald Inbal, Weiss Moran, Yakov Gila
Sabar Health-Home Hospital, Netanya, Israel.
Nursing Department, The Max Stern Yezreel Valley College, D.N. Emek Yezreel, 1930600, Israel.
Palliat Care Soc Pract. 2024 Nov 17;18:26323524241293821. doi: 10.1177/26323524241293821. eCollection 2024.
Home-based palliative care is a growing trend, necessitating a deeper understanding of the unique challenges faced by professional staff members in this setting. The shift to home-based care has been driven by advances in technology, changing demographics, and a move toward more patient-centered approaches. As a care setting, the home environment offers distinct characteristics, presenting both advantages and drawbacks for patients and healthcare providers.
This study aims to explore the experiences and perceptions of professional staff members providing palliative care in patients' homes.
A qualitative descriptive study.
Qualitative study with 36 home-based hospice professionals using questionnaires and interviews. Thematic analysis identified key themes in staff experiences and challenges.
The central theme of "The Professional Guest" highlights the hybrid identity and boundary role professional staff members must navigate, being both medical professionals and guests in the patient's domain. Four sub-themes emerged: (1) Observing and Applying, emphasizing the conscious scanning of the home environment to build trust and tailor care plans; (2) Asking for Permission, respecting the patient's territory and adapting to their norms; (3) Expecting the Unexpected, maintaining flexibility and improvising in unfamiliar situations; and (4) Preparing the Ground for Your Absence, equipping patients and families with comprehensive self-care guidance during professional staff members' absences.
The "Professional Guest" phenomenon captures the complexities of providing care in patient's homes, necessitating a delicate balance between professionalism and personal vulnerability. Specialized training programs and policies should be developed to support professional staff members in navigating this hybrid identity and effectively negotiating the boundaries between professional and personal spheres.
居家姑息治疗是一种日益增长的趋势，这就需要更深入地了解专业工作人员在这种环境中面临的独特挑战。向居家护理的转变是由技术进步、人口结构变化以及向更以患者为中心的方法推动的。作为一种护理环境，家庭环境具有独特的特点，给患者和医疗服务提供者带来了利弊。
本研究旨在探讨在患者家中提供姑息治疗的专业工作人员的经历和看法。
一项定性描述性研究。
对36名居家临终关怀专业人员进行定性研究，采用问卷调查和访谈。主题分析确定了工作人员经历和挑战中的关键主题。
“专业访客”这一核心主题突出了专业工作人员必须应对的混合身份和边界角色，他们既是医疗专业人员，又是患者领域的访客。出现了四个子主题：（1）观察与应用，强调有意识地审视家庭环境以建立信任并制定个性化护理计划；（2）请求许可，尊重患者的领域并适应其规范；（3）预料之外，在不熟悉的情况下保持灵活性并即兴应对；（4）为你的离开做好准备，在专业工作人员不在期间为患者和家属提供全面的自我护理指导。
“专业访客”现象体现了在患者家中提供护理的复杂性，需要在专业性和个人脆弱性之间取得微妙平衡。应制定专门的培训计划和政策，以支持专业工作人员应对这种混合身份，并有效地协调专业领域和个人领域之间的界限。
