专业照护者感知的儿童安宁疗护实践影响因素的质性研究  

Influencing Factors of Pediatric Hospice Care Practices Perceived by Professional Caregivers:A Qualitative Study

作　　者：成磊[1] 连逸飞 翟晓文 刘薇群 CHENG Lei;LIAN Yifei;ZHAI Xiaowen;LIU Weiqun(School of Nursing,Fudan University,Shanghai 200032,China;Department of Hematology and Oncology,Pediatric Hospital of Fudan University,Shanghai 201102,China;Department of Nursing,Pudong Zhoupu Hospital,Shanghai 201318,China)

机构地区：[1]复旦大学护理学院,上海200032 [2]复旦大学附属儿科医院血液肿瘤科,上海201102 [3]上海市浦东新区周浦医院护理部,上海201318

出　　处：《军事护理》2023年第4期11-14,共4页MILITARY NURSING

基　　金：美国中华医学基金会OC项目(#27-421);泰康溢彩公卫基金项目(XJJ-YCGW-2021009)。

摘　　要：目的深入了解专业照护者感知的儿童安宁疗护实践影响因素,为提升安宁疗护服务质量提供参考依据。方法2021年11月至2022年3月,目的抽样法选取上海市2所儿童专科医院和4所社区医院的3名医生、15名护士、3名社工为研究对象,采用现象学研究方法,对其进行深度访谈,对访谈资料进行转录、编码、分析、提炼主题。结果专业照顾者感知的儿童安宁疗护实践的影响因素分别来自微观系统(患儿的诊疗经历、对疾病的认知、身心需求)、中观系统(家庭成员对安宁疗护的认识、对安宁疗护信息的获取、情绪状态,专业照护者开展安宁疗护的意愿、服务能力,医疗机构的服务模式、资源配置)和宏观系统(社会文化、政策机制)3个层面。结论儿童安宁疗护实践面临多重影响,需要普及安宁疗护理念,增强社会各层面对其关注度和参与度,提升专业照顾者的服务能力,加强医院、社区、家庭安宁服务的连续性,开发适合国内临床情景的个性化安宁疗护服务,提高患儿和家庭的生活质量。Objective To explore the influencing factors of pediatric hospice care practices perceived by professional caregivers,and to provide reference for improving the quality of hospice care service.Methods From November 2021 to March 2022,3 doctors,15 nurses and 3 social workers from 2 children’s specialized hospitals and 4 community hospitals in Shanghai were interviewed in depth by phenomenological research methods.Results The influencing factors of pediatric hospice care practice perceived by professional caregivers came from three levels,including the micro system(diagnosis and treatment experience,disease cognition,physical and mental needs of children),the meso system(family members’understanding of hospice care,access to hospice care information,emotional state,professional caregivers’willingness and service ability to carry out hospice care,service mode and resource allocation of medical institutions)and the macro system(social culture,and policy mechanism).Conclusions Children’s hospice care practice is faced with multiple influences.It is necessary to popularize the concept of hospice care,attract the attention and participation of all levels of society,improve the service ability of professional caregivers,strengthen the continuity of pediatric services in hospitals,communities and families,develop personalized hospice care services suitable for domestic clinical situations,and improve the quality of life of children and families.

关 键 词：儿童 安宁疗护 专业照护者 质性研究 

分 类 号：R473.72[医药卫生—护理学] R48[医药卫生—临床医学]