高年资肿瘤科护士应对患者死亡成长经历的质性研究

Growth experiences of senior oncology nurses in coping with patients＇ death： a qualitative study

目的了解高年资护士应对患者死亡的成长经历，为临床护理管理和教学提供参考依据。方法采用现象学研究方法，对25名高年资护士进行深度访谈，采用主题分析法收集整理资料、分析提炼主题。结果提炼出3个主题，分别为成长的变化、成长的途径以及未满足的需求。高年资护士通过不断的临床经验积累和带教分享，对死亡有了更加明确的认知、情绪反应发生了理性转变、应对策略也日益成熟，能较好地应对患者死亡，但是他们在心理调试、社会支持以及专业理论知识需求方面仍需要一定的帮助。结论建议护理管理者重视高年资肿瘤科护士的经验分享和带教作用，关注高年资肿瘤科护士的身心健康并提供专业的心理社会支持以帮助其积极应对负性事件，同时为全体护士提供系统的临终关怀／死亡教育相关的知识培训，最终促进肿瘤科护士的职业成长。

Objective To understand the growth experiences of senior nurses in coping with the death of patients so as to provide reference for clinical nursing management and teaching. Methods A phenomenological research method of qualitative study was employed in this study. Twenty-five senior nurses were in-depth interviewed with semi-structured interview guide. Thematic analysis method was adopted to collect and analyze the data, which were then organized into themes and subthemes. Results Three themes were ＂changes in growth＂ ＂ways to grow＂ and ＂unmet needs＂. Senior nurses could cope with patients＇ death well through accumulation and sharing of clinical experience, as they reorganized of death more definitely, their emotional response transferred reasonable, their coping strategy became matured, whereas the senior nurses still need help in the areas of psychological adaption, social support and professional theory education. Conclusions It is suggested that nursing managers should value the experience sharing and teaching function of senior oncology nurses, pay attention to the physical-mental health of senior nurses and provide professional psychosocial support to them. Otherwise, it is important to provide all oncology nurses with systematic knowledge training concerning hospice/death education to promote their career development ultimately.