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新冠疫情期间的死亡与临终——对护理人员压力因素的质性评估

Death and dying during the COVID-19-pandemic - A qualitative evaluation of stress factors for nursing staff.

作者信息

Kiefer Lea, Bösner Stefan, Graw Jan Adriaan, Volberg Christian

机构信息

Institute of General Practice and Family Medicine, Philipps-University Marburg, Germany.

Department of Anaesthesiology and Intensive Care Medicine, Ulm University Hospital, Germany.

出版信息

Palliat Care Soc Pract. 2025 Jul 28;19:26323524251355655. doi: 10.1177/26323524251355655. eCollection 2025.

Abstract

BACKGROUND

The COVID-19 pandemic posed an unprecedented challenge for the healthcare system worldwide and led to high levels of psychosocial stress, particularly among nursing staff working in special COVID-19 wards. As previous studies have shown, this stress has had a profound impact on mental health, underscoring the need for further research to deepen our understanding of these effects.

OBJECTIVES

To investigate the experiences of nursing staff working on special COVID-19 wards during the COVID-19 pandemic with regard to the death and dying of patients.

METHODS

To uncover aspects that might have remained unobserved in a quantitative survey, a qualitative research design was chosen for data collection. Using a semi-structured interview guide, we interviewed 14 nurses about their experiences. The data was then analysed using a qualitative content analysis according to Mayring.

RESULTS

Nursing staff were exposed to a particularly high level of stress. The reasons for this included the lack of opportunities for end-of-life care, patients dying alone, an above-average level of confrontation with death and serious disease progression and finally, limited treatment options and specialised care for deceased patients. These factors led to moral injuries.

CONCLUSION

The results emphasise the urgency of better preparing nursing staff for future crises, providing psychosocial support and developing preventive strategies against moral distress. The promotion of resilience and the creation of conditions that prevent moral injury are essential to minimise the long-term effects of such stress and to protect the mental health of nursing staff in the long term.

TRIAL REGISTRATION

Registered in the German Register of Clinical Studies under the number DRKS00030425.

摘要

背景

新冠疫情给全球医疗系统带来了前所未有的挑战,并导致了高度的心理社会压力,尤其是在新冠疫情特别病房工作的护理人员中。正如先前的研究表明,这种压力对心理健康产生了深远影响,凸显了进一步开展研究以加深我们对这些影响理解的必要性。

目的

调查新冠疫情期间在新冠疫情特别病房工作的护理人员在患者死亡和临终方面的经历。

方法

为了揭示在定量调查中可能未被观察到的方面,选择了定性研究设计来收集数据。使用半结构化访谈指南,我们采访了14名护士关于他们的经历。然后根据迈林的方法使用定性内容分析法对数据进行分析。

结果

护理人员面临着特别高的压力水平。其原因包括缺乏临终关怀机会、患者孤独离世、与死亡和严重疾病进展的接触水平高于平均水平,以及最后,针对已故患者的治疗选择和专科护理有限。这些因素导致了道德伤害。

结论

结果强调了为护理人员更好地应对未来危机做好准备、提供心理社会支持以及制定预防道德困扰策略的紧迫性。促进恢复力和创造防止道德伤害的条件对于将此类压力的长期影响降至最低以及长期保护护理人员的心理健康至关重要。

试验注册

在德国临床研究注册中心注册,注册号为DRKS00030425。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d5/12304608/34ee86840797/10.1177_26323524251355655-fig1.jpg

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