应对环回结构模型视角下安宁疗护团队压力应对策略的多层实践探索  

An Application of the Coping Circumplex Model for Understanding the Multilevel Practice Strategies in Hospice Care Teams

作　　者：郭晴 王晔安 宋雅君 Guo Qing;Wang Yean;Song Yajun

机构地区：[1]华东理工大学社会与公共管理学院社会学系 [2]北京师范大学政府管理学院 [3]华东理工大学社会与公共管理学院

出　　处：《都市社会工作研究》2024年第1期193-212,239-240,共22页Research on Urban Social Work

摘　　要：本文以应对环回结构模型为基础,生态系统理论为依据,通过访谈四家上海社区卫生服务中心的安宁疗护团队,探索并梳理了安宁疗护团队在常见工作压力面前采取的应对策略。研究发现,当团队成员面对死亡病痛时,个体会自我调节或难以承受离职,团队成员互相陪伴,院方提供资金团建、请第三方为其评估减压;团队成员运用同理和与病患及家属的轮番沟通来消除医患误会、达成共识,受访院方制定相应的规章制度来减少医患的预期偏差;团队成员还会互帮互助应对高压工作;而当社工护士掌握的技能无法满足实际需求时,除了团队之间互相学习鼓励,院方会有针对性地组织相应的培训。结果显示,团队及院方采取的多为正面问题解决方式。个体与团队采取的正面情绪应对形式单一。在同一压力源面前,个体、团队、院方采取的应对策略偏重、效果都不同。To understand the hospice care teams'coping strategies for work-related stress,we interviewed four community health service centers in Shanghai.Using the Coping Circumplex Model and Ecological Systems Theory,we found three levels of coping strategies under three major types of stress.When faced with death and pain,individual members may manage their stress through self-regulation or quitting the job,the team would provide mutual support and the centers would hire a third party for team building or stress relief.When faced with conflicting expectations,the team would show empathy and improve communication to eliminate misunderstanding and reach consensus,the centers would clarify all doubts in patient consent before admission.When faced with high work intensity and a lack of skills,the team would provide collaborative leaning and mutual assistance,and the centers would organize corresponding trainings.Our results indicated that the teams and centers adopted mostly positive problem-solving copings.The forms of positive emotional coping adopted by individual members and the team were not very diversified.When faced with the same stress,the coping strategies and their effects varied with levels.

关 键 词：安宁疗护 应对环回结构模型 生态系统理论 

分 类 号：C916[经济管理] R197.1[社会学]