医护人员对新生儿安宁疗护感受和经验的质性研究

Qualitative research on the feeling and experience of medical staff on neonatal hospice care

目的 了解医务人员关于新生儿安宁疗护的感受和经验,为新生儿安宁疗护的开展提供参考依据。方法 采用描述性质性研究,于2020年5月—7月对13名新生儿科医生和护士、护理管理者、医务社会工作者、安宁疗护医生和护士进行半结构式访谈,运用定向内容分析法对资料进行分析。结果 提炼出5个主题,临终新生儿的需求、临终新生儿家长的需求、医患沟通、安宁疗护的介入时机、安宁疗护的多学科团队。结论 新生儿安宁疗护要关注临终新生儿减少疼痛、舒适护理、营养支持、安全感等需求,关注新生儿家长陪伴患儿、情感支持、信息支持、专业指导、被理解和尊重等需求,要促进有效及良好的医患沟通,介入时需结合患儿疾病情况和家长意愿,多学科协作是开展新生儿安宁疗护的良好模式。

Objective To understand the feelings and experiences of medical staff on neonatal hospice care,and to provide a reference for the development of neonatal hospice care. Methods Descriptive research methods were used to conduct semi-structured interviews with 13 neonatal clinicians and clinical nurses,nursing managers,medical social workers,hospice care doctors and nurses,and the data was analyzed using targeted content analysis. Results5 themes were extracted,including the needs of the dying newborn,the needs of the family of the dying newborn,the communication between doctors and patients,the timing of intervention for hospice care,and the multidisciplinary team of hospice care. Conclusion Medical staff should pay attention to the needs of dying newborns for pain reduction,comfort care,nutritional support,sense of security,and the needs of families to accompany children,emotional support,information support,professional guidance,understanding and respect,when conducting the neonatal hospice care of newborn babies. Effective and good communication between doctors and patients should be promoted. It is needed to consider the timing of intervention and the child’s disease condition and family will.Multidisciplinary collaboration is a good model for the development of neonatal hospice care.