基于扎根理论的肿瘤科护士临终关怀能力框架构建
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摘要
目的探索构建护士照护患肿瘤的临终患者应有的临终关怀能力框架,为护理专业教育及临床继续教育提供参考。方法选取3所综合医院的肿瘤科内29名医务人员、患肿瘤的临终患者以及患者家属,采用扎根理论分析法对其进行面对面的半结构式访谈,并应用Nvivo 11软件对获得的资料进行对比、分析。结果最终确立基于"满足需求"的肿瘤科护士临终关怀能力框架,7项一级要素、16项二级要素。结论以满足需求为基础的肿瘤科护士临终关怀能力框架由临终关怀知识、交流能力、教育能力、支持性照护、自我发展、个人特质、人际关系7个维度构成。
Objective To construct a framework of hospice care ability of nurses, and to provide reference for nursing professional education and clinical continuing education. Methods Twenty-nine medical staff, dying patients with tumors and family members in oncology department from 3 general hospitals were selected. Face-to-face semi-structured interviews were conducted through grounded theory analysis, and the data obtained were compared using Nvivo.11 software. Results The constructed hospice care competence framework based on satisfying demands consisted of 7 primary and 16 secondary elements. Conclusion The hospice care competence framework for oncology nurses based on need satisfying demands is composed of 7 dimensions: hospice knowledge,communication skills, educational ability, supportive care, self-development, personal traits, and interpersonal relationships.
Objective To construct a framework of hospice care ability of nurses, and to provide reference for nursing professional education and clinical continuing education. Methods Twenty-nine medical staff, dying patients with tumors and family members in oncology department from 3 general hospitals were selected. Face-to-face semi-structured interviews were conducted through grounded theory analysis, and the data obtained were compared using Nvivo.11 software. Results The constructed hospice care competence framework based on satisfying demands consisted of 7 primary and 16 secondary elements. Conclusion The hospice care competence framework for oncology nurses based on need satisfying demands is composed of 7 dimensions: hospice knowledge,communication skills, educational ability, supportive care, self-development, personal traits, and interpersonal relationships.
引文
[1]桂欣钰,杨晶,杨丹,等.中国本土舒缓医学的发展现状和前景[J].医学与哲学,2016, 37(24):83-87.DOI:10.12014/j.issn.1002-0772.2016.12b.27.
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[9]杨洪菊.综合医院肿瘤科医务人员临终关怀认知的质性研究[J].全科护理, 2017,15(9):1118-1120.DOI:10.3969/j.issn.1674-4748.2017.09.038.
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[11]Tsatali M. Book Review:Caregiver Stress and Staff Support in Illness,Dying and Bereavement[J]. Palliative Medicine,2013,27(1):94-95.DOI:10.1177/0269216312467276a.
[12]Heaston S, Beckstrand R L, Bond A E, et al.Emergency Nurses’ Perceptions of Obstacles and Supportive Behaviors in End-of-life Care[J]. J Emerg Nurs,2006,32(6):477-485.DOI:10.4037/ajcc2009497.
[13]孙向红,王晓芳.综合医院临终关怀专业护理队伍的建设[J].护理学报,2018,25(2):14-17.DOI:10.16460/j.issn1008-9969.2018.02.014.
[14]李永红,苏蕾,王章琴,等.死亡教育对晚期癌症患者生活质量的影响[J].重庆医学,2016, 45(30):4276-4279.DOI:10.3969/j.issn.1671-8348.2016.30.032.
[15]Tschann J M, Kaufman S R, Micco G P. Family Involvement in End-of-Life Hospital Care[J]. J Am Geriatr Soc,2003,51(6):835-840.DOI:10.1046/j.1365-2389.2003.51266.x.
[16]Libo-On I L, Nashwan A J.Oncology Nurses’ Perceptions of End-of-Life Care in a Tertiary Cancer Centre in Qatar[J].Int J Palliat Nurs,2017, 23(2):66-73.DOI:10.12968/ijpn.2017.23.2.66.
[17]John Costello R N. Dying Well:Nurses’Experiences of‘Good and Bad’Deaths in Hospital[J]. J Adv Nurs, 2010, 54(5):594-601.DOI:10.1111/j.1365-2648.2006.03867.x.
[18]Steinhauser K E, Clipp E C, Mcneilly M, et al. In Search of a Good Death:Observations of Patients, Families, and Providers[J]. Ann Inter Med, 2000, 132(10):825-32.DOI:10.7326/0003-4819-132-10-200005160-00011.
[19]周霜,王海容,程文玉,等.临终关怀立法现状及探索[J].医学与哲学,2017,38(11):57-60.DOI:10.12014/j.issn.1002-0772.2017.06a.15.
[20]陈德芝.临终关怀:为临终患者提供生理和心理的全面照护—上海临终关怀(舒缓疗护)伦理与实践国际研讨会撷英[J].医学与哲学,2014,35(11):95-97.
[2]杜冰莹,荀臻臻,芦方颖,等.上海市临终关怀事业现状调查[J].中国医学伦理学,2016, 29(1):173-177.
[3]Connolly M, Charnley K, Regan J. A Review of Palliative Care Competence Frameworks:Prepared for the Palliative Care Competency Framework Development Project Steering Group[J].Clujul Medical,2012,86(2):117-120.
[4]赵晓婕,杨逸,吴啊萍,等.晚期癌症患者对临终关怀需求的调查分析[J].护理学杂志,2015, 30(9):27-30.DOI:10.3870/hlxzz.2015.09.027.
[5]苏永刚.中英临终关怀比较研究[D].济南:山东大学, 2013.
[6]Edwardsjones A. Qualitative Data Analysis with NVivo[J]. J Psychiatr Ment Health Nurs,2010, 15(10):868-868.DOI:10.1111/j.1365-2850.2008.01257.x.
[7]董奇.心理与教育研究方法[M].北京:北京师范大学出版社,2004.
[8]郭辉,李小惠,范爱飞,等.某院肿瘤相关科室医务人员临终关怀认知现状调查[J].护理学报, 2009, 16(6B):9-11.DOI:10.3969/j.issn.1008-9969.2009.12.004.
[9]杨洪菊.综合医院肿瘤科医务人员临终关怀认知的质性研究[J].全科护理, 2017,15(9):1118-1120.DOI:10.3969/j.issn.1674-4748.2017.09.038.
[10]Mcquellon R P, Cowan M A.Turning toward Death Together:Conversation in Mortal Time[J]. Am J Hosp Palliat Me,2000,17(5):312-318.DOI:10.1177/104990910001700508.
[11]Tsatali M. Book Review:Caregiver Stress and Staff Support in Illness,Dying and Bereavement[J]. Palliative Medicine,2013,27(1):94-95.DOI:10.1177/0269216312467276a.
[12]Heaston S, Beckstrand R L, Bond A E, et al.Emergency Nurses’ Perceptions of Obstacles and Supportive Behaviors in End-of-life Care[J]. J Emerg Nurs,2006,32(6):477-485.DOI:10.4037/ajcc2009497.
[13]孙向红,王晓芳.综合医院临终关怀专业护理队伍的建设[J].护理学报,2018,25(2):14-17.DOI:10.16460/j.issn1008-9969.2018.02.014.
[14]李永红,苏蕾,王章琴,等.死亡教育对晚期癌症患者生活质量的影响[J].重庆医学,2016, 45(30):4276-4279.DOI:10.3969/j.issn.1671-8348.2016.30.032.
[15]Tschann J M, Kaufman S R, Micco G P. Family Involvement in End-of-Life Hospital Care[J]. J Am Geriatr Soc,2003,51(6):835-840.DOI:10.1046/j.1365-2389.2003.51266.x.
[16]Libo-On I L, Nashwan A J.Oncology Nurses’ Perceptions of End-of-Life Care in a Tertiary Cancer Centre in Qatar[J].Int J Palliat Nurs,2017, 23(2):66-73.DOI:10.12968/ijpn.2017.23.2.66.
[17]John Costello R N. Dying Well:Nurses’Experiences of‘Good and Bad’Deaths in Hospital[J]. J Adv Nurs, 2010, 54(5):594-601.DOI:10.1111/j.1365-2648.2006.03867.x.
[18]Steinhauser K E, Clipp E C, Mcneilly M, et al. In Search of a Good Death:Observations of Patients, Families, and Providers[J]. Ann Inter Med, 2000, 132(10):825-32.DOI:10.7326/0003-4819-132-10-200005160-00011.
[19]周霜,王海容,程文玉,等.临终关怀立法现状及探索[J].医学与哲学,2017,38(11):57-60.DOI:10.12014/j.issn.1002-0772.2017.06a.15.
[20]陈德芝.临终关怀:为临终患者提供生理和心理的全面照护—上海临终关怀(舒缓疗护)伦理与实践国际研讨会撷英[J].医学与哲学,2014,35(11):95-97.