安宁疗护护士职业悲伤体验的质性研究

An interpretive phenomenological study on the professional grief experience of hospice nurses

目的了解安宁疗护护士在经历患者病死事件后的内心感受及悲伤体验。方法采用目的抽样结合滚雪球抽样的方法,于2020年11月—2021年3月选取广州市4所社区卫生服务中心和2所医院的15名安宁疗护护士进行半结构式深度访谈。运用解释现象学分析法分析访谈资料,提炼主题。结果安宁疗护护士经历患者病死事件的职业悲伤体验可归纳为3个主题,包括职业悲伤的特征(被剥夺的悲伤、悲伤易被唤起)、应对方式(回避、否认、心理脱离、调整对患者病死的认知、寻求支持)和职业悲伤的累积影响(职业倦怠、成长)。结论安宁疗护护士普遍存在被剥夺的悲伤,且悲伤易被唤起,具有隐匿性、长期性和累积性的特点;调适悲伤的方式消极与积极并存,成长者与职业倦怠者均存在,建议对安宁疗护护士提供职业悲伤的教育和组织支持,引导其正确表达,促进成长。

Objective To understand the inner feelings and grief experience of hospice nurses who experienced the death of patients.Methods Using the method of objective sampling combined with snowball sampling,15 hospice nurses from 4 community health service centers and 2 hospitals in Guangzhou were selected for semi-structured in-depth interviews from November 2020 to March 2021.The interview data were analyzed by interpretative phenomenological analysis to refine the themes.Results The grief experience of hospice nurses in patients’death events can be summarized into 3 themes,namely characteristics of grief(disenfranchised grief,and grief is easily recalled),coping style,long-term effect(job burnout,growth).Conclusion Disenfranchised grief is common among hospice nurses,which is usually easy to be recalled.Grief has the characteristics of concealment,long-term and accumulation.Nurses have both negative and positive ways for adjustment of grief.The harvesters and the people who are job burnout both exist in the group.It is suggested that in the future formal education and support for professional grief should be provided to the hospice nurses,to guide their correct expression and promote their growth.