Lagerin Annica, Melin-Johansson Christina, Holmberg Bodil, Godskesen Tove, Hjorth Elin, Junehag Lena, Hagelin Carina Lundh, Ozanne Anneli, Sundelöf Johan, Udo Camilla
Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden.
Department of Health Care Sciences/Nursing, Mid Sweden University, Kunskapens väg 8, Östersund, 831 25, Sweden.
BMC Palliat Care. 2025 Feb 19;24(1):47. doi: 10.1186/s12904-025-01681-x.
Communication is central to implementing palliative care (PC) and effective interdisciplinary team functioning. Communication about existential issues is often urgent in PC, yet interdisciplinary teams frequently lack the time and education to meet these communication needs. Thus, more knowledge of existential conversations in different PC contexts is required.
This study aimed to gain an in-depth understanding of healthcare professionals' (HCPs) experiences of existential conversations with patients with PC needs and their next-of-kin by generating a theoretical model.
Seven focus-group interviews that included 26 HCPs who worked with PC patients in different care settings were carried out in 2020 and 2022. The grounded theory method was used to analyse and compare data from the interview transcripts.
The HCPs' primary concern in daily work was establishing a trusting relationship, a prerequisite for enabling existential conversations with a person with PC needs and/or their next-of-kin. The main concern was characterised by the core category maintaining presence and four categories describing interdisciplinary strategies that the HCPs used to achieve a trusting relationship and enable existential conversations in the late phase of life. Several potential barriers also hindered existential conversations. The theoretical model 'meaningful existential conversations in PC' was constructed.
The interdisciplinary strategies used to establish existential conversations, the potential barriers to these conversations and the model we present can be used as a basis for reflection in professional collaborative learning in PC, as a tool for teachers in educational PC programmes and as a guide for HCPs in PC.
沟通是实施姑息治疗（PC）和实现有效的跨学科团队协作的核心。在姑息治疗中，关于存在性问题的沟通往往十分紧迫，但跨学科团队常常缺乏时间和相关培训来满足这些沟通需求。因此，需要更多关于不同姑息治疗背景下存在性对话的知识。
本研究旨在通过构建一个理论模型，深入了解医疗保健专业人员（HCPs）与有姑息治疗需求的患者及其家属进行存在性对话的经历。
在2020年和2022年进行了七次焦点小组访谈，访谈对象包括26名在不同护理环境中为姑息治疗患者提供服务的医疗保健专业人员。采用扎根理论方法对访谈记录中的数据进行分析和比较。
医疗保健专业人员在日常工作中的主要关注点是建立信任关系，这是与有姑息治疗需求的患者及其家属进行存在性对话的先决条件。主要关注点的特征是核心类别“保持在场”以及四个描述医疗保健专业人员在生命末期用于建立信任关系和促成存在性对话的跨学科策略的类别。一些潜在障碍也阻碍了存在性对话。构建了“姑息治疗中有意义的存在性对话”理论模型。
用于建立存在性对话的跨学科策略、这些对话的潜在障碍以及我们提出的模型可作为姑息治疗专业协作学习中的反思基础、姑息治疗教育项目教师的工具以及姑息治疗中医疗保健专业人员的指南。
