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中国肿瘤护士照顾临终患者的经验:一项定性研究。

Chinese oncology nurses' experience on caring for dying patients who are on their final days: a qualitative study.

机构信息

Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.

College of Nursing, University of Massachusetts Amherst, Amherst, USA.

出版信息

Int J Nurs Stud. 2015 Jan;52(1):288-96. doi: 10.1016/j.ijnurstu.2014.09.009. Epub 2014 Oct 5.

Abstract

BACKGROUND

Caring for dying patients is stressful but an unavoidable responsibility of nurses. However, little is known about Chinese oncology nurses' experience of caring for dying cancer patients who are in their final days.

PURPOSE

To elucidate Chinese oncology nurses' experience of caring for dying cancer patients.

METHODS

This is a qualitative descriptive study, semi-structured interviews was utilized to explore views of purposive sample of 28 nurses who have been taking care of terminally ill patients in a cancer hospital in Tianjin, mainland China. Transcripts were entered into NVivo. Qualitative thematic analysis was used to analyze the data for significant statements and phrases that in turn were organized into themes and sub-themes.

RESULTS

Five themes were identified in the data: end-of-life care for dying cancer patients, end-of-life care for family members, cultural sensitivity and communication, moral distress and self-limitations, self-reflection and benefit-finding. Death is a taboo in traditional Chinese culture. This increases the difficulty of effective communication between nurses, patients and families. Although nurses suffered emotional distress when caring for dying cancer patients, these experiences helped them to reflect on the meaning of death and life, and positively influenced their daily lives, attitudes and behaviors toward caring for the dying. Chinese nurses had strong willingness to offer quality end-of-life care to patients and families, however, they suffered moral distress because of self-limitation, lack of knowledge and confidence and inexperience in psychological care.

CONCLUSIONS

End-of-life care in China reflects and has been influenced by the traditional Chinese culture. Chinese nurses reported suffering but also benefiting from their experiences. End-of-life cancer care training is needed by Chinese oncology nurses, especially for those who are younger and less experienced.

摘要

背景

照顾临终患者是护士的一项压力很大但又不可避免的责任。然而,对于中国肿瘤科护士在临终阶段照顾癌症临终患者的体验知之甚少。

目的

阐明中国肿瘤科护士照顾癌症临终患者的体验。

方法

这是一项定性描述性研究,采用半结构式访谈法,对在中国天津市一家癌症医院照顾终末期患者的 28 名护士进行了有目的的抽样调查。将转录本输入 NVivo。采用定性主题分析对数据进行分析,以提取有意义的陈述和短语,进而将其组织成主题和子主题。

结果

数据中确定了五个主题:癌症临终患者的临终关怀、临终患者家属的关怀、文化敏感性和沟通、道德困境和自我限制、自我反思和获益发现。在传统的中国文化中,死亡是一个禁忌。这增加了护士、患者和家属之间进行有效沟通的难度。尽管护士在照顾癌症临终患者时会感到情绪困扰,但这些经历帮助他们反思死亡和生命的意义,并对他们的日常生活、对临终关怀的态度和行为产生积极影响。中国护士有强烈的意愿为患者和家属提供优质的临终关怀,但由于自我限制、缺乏知识和信心以及在心理关怀方面缺乏经验,他们会感到道德困境。

结论

中国的临终关怀反映并受到中国传统文化的影响。中国护士报告说,他们在经历中既有痛苦也有获益。中国肿瘤科护士需要接受临终癌症护理培训,尤其是那些年轻和经验较少的护士。

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