应用焦点小组访谈法探讨肿瘤科护士交流困难

Application of focus group interview to explore oncology nurse communication difficulties

目的 探讨肿瘤科护士与患者及患者家属之间交流困难的原因以及影响并获得相关建议.方法 本研究采用焦点小组访谈法研究定性资料,选取重庆医科大学附属第一医院肿瘤科护士作为研究对象,运用方便抽样法抽取同质性样本,共纳入24名肿瘤科护理人员,并将之随机分为3组（每组8人）进行访谈.采用内容分析法处理和分析数据.结果 肿瘤科护士产生交流困难的原因：患者及家属提出负面问题、无效沟通、与患者及家属存在矛盾.交流困难对肿瘤科护士工作具有不利影响;肿瘤科护士认为交流困难主要原因在于制度上的不足并提出了相关建议.结论 肿瘤科护士在长期的工作中,易与患者及家属产生交流困难,尤其是在以下危机期：肿瘤早期诊断期、复发期、癌症晚期以及某些特殊日期（生日、聚会等）.肿瘤科护士与患者及家属之间需要相互支持.解决交流困难有利于减少患者及家属的焦虑、沮丧、无助等不良情绪,从而提高护理质量以及患者的生存质量.

Objective To explore the reason and influence of communication difficulties between oncology nurses and patients or families of patients,and to obtain some relevant advice about communication difficulties.Methods This study used focus group to interview 24 oncology nurses who were selected from the First Affiliated Hospital of Chongqing Medical University by homogeneous sampling method,and were randomly divided into three groups （8 in each group）.The data were processed and analyzed by content analysis.Results The reasons why oncology nurses had communication difficulties with patients and their families were as follows：putting forward negative problems about their disease,ineffective communication and conflicts with patients,families.The communication difficulties showed negative effect on oncology nurses.Oncology nurses thought that the main reason of communication difficulties lied in the deficiency of institution and propounded the suggestion to resolve it.Conclusions oncology nurses were tend to have difficulty in communicating with patients and their families in the long-term work,especially in the period of crisis：early diagnosis of tumor stage,relapse,advanced cancer and some special dates （birthday,parties etc.）.Therefore,oncology nurses,patients and their families need to be supported.To solve the difficulties of communication could reduce the negative emotions of patients and their family,such as anxiety,frustration,helplessness,so as to improve the quality of care and life of patients.