影响肿瘤姑息护理培训内容制定的因素分析

The Factors Influencing the Training Contents Construction of Tumor Palliative Care

目的分析肿瘤医院护士对姑息护理培训内容的意见,将护士的年龄、工龄和职称与其认为培训内容的重要性进行相关性分析,以确定肿瘤姑息护理培训内容的重点。方法2007年5月,参考美国ELENC临终关怀协会提出的9模块教育内容、威斯康星大学的姑息护理课程、澳大利亚姑息护理协会制定的培训内容,提出我国姑息护理培训内容,包括姑息护理概述、症状护理、心理护理、沟通交流、道德伦理观念、终末护理。调查对象根据经验和实际工作需要对内容的重要性做出评判。采用问卷调查某肿瘤医院的148名临床护士,回收有效问卷131份。运用SPSS 10.0统计软件对数据进行处理,采用描述性统计分析及非参数Spearman秩相关检验。结果(1)培训内容的重要性依次为:沟通交流、心理护理、症状护理、道德伦理观念、终末护理、姑息护理概述;(2)Spearman秩相关检验显示:护理人员的工龄与其认为心理护理(rs=0.240;P=0.006)、沟通交流(rs=0.201;P=0.022)、道德伦理观念(rs=0.233;P=0.008)培训的重要性成正相关;护理人员的职称与其认为沟通交流培训的重要性成正相关(rs=0.187;P=0.034)。护理人员的学历与其认为培训的重要性成负相关,但无统计学意义。结论沟通交流、心理护理是姑息护理培训的重点,应着重提高年轻护士对心理护理、沟通交流、道德伦理观念培训重要性的认识及相关能力;护士均未接受过姑息护理相关培训,制定的培训内容应适用于各学历层次的护理人员。

Objective To construct the training contents of tumor palliative care by analyzing the opinions of the nurses from tumor hospital on the training contents of tumor palliative care and carrying out correlative analysis over their opinions and their age, service standing and professional title. Methods In May 2007, the training contents of tumor palliative care were constructed based on the 9 modules advanced by ELENC in U.S., the palliative care courses of Wisconsin University and the contents regulated by Australian Palliative Care Association. The contents included an overview on palliative care, symptom nursing, mental care, communication skills, moral and ethics and terminal nursing. A questionnaire was used into the investigation among 148 nurses from a tumor hospital, 131 sheets valid. SPSS10.0 was used to treat the collected data, with descriptive statistical analysis and Spearman non-parameter rank correlation test. Results （1） In the order of content importance, communication skills ranked the first, followed by mental care, symptom nursing, moral and ethics, terminal nursing and overview on palliative care. （2） Spearman rank correlation test showed： The service standing was positively correlated to mental care （r,=0.240; P=0.O06）, communicative skills （r,=0.201; P=0.022）, and moral and ethics （r,=0.233; P=0.O08） and so it was with the professional title and training on communicative skills （r,=0.187; P=0.034）. The education was negatively correlated to training, but with no statistical significance. Conclusion Communicative skills and mental care are the key points included in palliative care training. We should put weight on the enhancement of young nurse＇ s recognition to the importance of the training of mental care, communicative skills, moral and ethics. The nurses at all levels have not received training on palliative care, so the construction of training contents should be apt to nurses with different education backgrounds.