安宁共照模式下综合性医院临床护士开展安宁疗护工作影响因素的质性研究

Qualitative research on influencing factors of hospice care carried out by clinical nurses in general hospitals under the mode of hospice shared care model

目的探究安宁共照模式下综合性医院临床护士开展安宁疗护工作的影响因素,进一步提升综合性医院安宁疗护的服务质量。方法采用描述性现象学的研究方法,于2023年6—9月通过目的抽样选择浙江大学医学院附属邵逸夫医院13名临床护士,基于能力-机会-动机-行为模型开展半结构式访谈,运用Colaizzi 7步分析法进行归纳分析并提炼主题。结果13名临床护士中,男3名,女10名,年龄24~38岁。共提炼出3个主题及11个亚主题:能力因素(理论知识无法满足临床需求、临床实践能力欠缺、自我情绪调节能力不足)、动机因素(开展安宁共照的意愿、自身职业获益感、职业认同感、照护压力感知、安宁疗护自我效能)、机会因素(儒家文化的影响、医院安宁共照模式系统化建设、多元外部支持)。结论在安宁共照模式下临床护士开展安宁疗护工作受内部因素和外部因素影响。护士可以通过多途径学习,发现积极的工作体验,运用多维度支持系统,为患者提供优质的安宁疗护服务。

ObjectiveTo explore the influencing factors of clinical nurses in general hospitals to carry out hospice care under hospice shared care model,and further improve the quality of hospice care in general hospitals under this mode.MethodsUsing the descriptive phenomenological research method,13 clinical nurses from Sir Run Run Shaw Hospital Affiliated to Medical School of Zhejiang University were selected by purposive sampling from June to September 2023.Semi-structured interviews were conducted based on the capacity opportunity-motivation-behavior model,and Colaizzi′s 7-step analysis method was used to summarize and refine the theme.ResultsThere were 3 males and 10 females,aged 24-38 years old.Three themes and 11 sub-themes were extracted in this study:ability factors(theoretical knowledge cannot meet clinical needs,lack of clinical practice ability,insufficient self emotional regulation ability),motivation factors(willingness to carry out hospice shared care model,sense of professional benefit,professional identity,perception of care pressure,hospice care self-efficacy),opportunity factors(the influence of Confucian culture,systematic construction of hospice shared care model in hospitals,and multiple external support).ConclusionsNurses'hospice care under hospice shared care model is affected by internal and external factors.Nurses can learn through multiple channels,find positive work experience,and use multi-dimensional support system to provide high-quality hospice care services for patients.