美国跨学科临终关怀临床医生的全国抽样调查:对理由的内容分析,他们是否愿意在病人死亡的整个过程中,通过医疗协助进行临终关怀。

IF 2.7 Q2 HEALTH CARE SCIENCES & SERVICES
Palliative Care and Social Practice Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI:10.1177/26323524241288881
Todd D Becker, Cindy L Cain, John G Cagle, Joan K Davitt, Nancy Kusmaul, Paul Sacco
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引用次数: 0

摘要

背景:尽管临终关怀医疗援助(MAID)合法化在美国不断扩大,但对其临床提供的态度,尤其是临床医生在场方面的态度的研究却很有限:本研究旨在探讨临终关怀医生、护士、社工和牧师对通过 MAID 帮助病人死亡的态度。目的包括:(1)描述通过 MAID 在患者死亡过程中在场的意愿;(2)描述愿意在场的理由:我们采用了横断面设计:美国跨学科临终关怀临床医生(N = 413)通过 Qualtrics 完成了一项自我管理的混合方法调查。在定性调查之前,有一个定量项目评估参与者是否愿意(不愿意、不确定、愿意)通过 MAID 在患者死亡过程中全程陪伴,定性调查则询问他们之前的回答背后的理由。定量回答通过频率和百分比进行描述。使用归纳编码法对每个定量子样本中的定性回答进行内容分析,以确定其表层含义:愿意到场的参与者(n = 305 [74%])将其意愿归因于个人支持、优质临床护理的定义以及专业培训的价值观。一些人参与了边界设定,描述了他们愿意出席的特定条件。不愿意参与的人员(n = 63 [15%])指出,他们个人反对 MAID 的概念,个人反对参与 MAID,并认为 MAID 与医疗保健不符。那些不确定的参与者(n = 45 [11%])则以矛盾和缺乏经验作为回答的前提,这两种情况都妨碍了他们形成明确的立场:尽管四分之三的参与者愿意在MAID期间在场,但定性回答显示出定量子样本内部和之间存在很大的细微差别。安宁疗护临床医生将受益于更多与 MAID 相关的专业指导和支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Willingness to be present throughout patient death via medical aid in dying in a national sample of interdisciplinary US hospice clinicians: a content analysis of rationales.

Background: Although medical aid in dying (MAID) legalization continues to expand across the United States, limited research has elucidated attitudes toward its clinical provision, especially in terms of clinician presence.

Objective: The objective of the current study was to explore attitudes toward presence throughout a patient's death via MAID in hospice physicians, nurses, social workers, and chaplains. Aims included (1) characterizing willingness to be present throughout patient death via MAID and (2) describing rationales for willingness.

Design: We employed a cross-sectional design.

Methods: A national convenience sample of interdisciplinary hospice clinicians in the United States (N = 413) completed a self-administered, mixed-method survey via Qualtrics. A quantitative item assessing participants' willingness (no, unsure, yes) to be present throughout a patient's death via MAID preceded a qualitative probe inquiring about their rationales behind their previous response. Quantitative responses were characterized through frequencies and percentages. Qualitative responses within each resulting quantitative subsample were content analyzed for surface-level meaning using inductive coding.

Results: Participants who were willing to be present (n = 305 [74%]) attributed their willingness to personal support, definitions of quality clinical care, and values from their professional training. Some engaged in boundary setting, describing particular conditions under which they would be willing to be present. Those who were unwilling (n = 63 [15%]) noted personal objections to the concept of MAID, personal objections to MAID participation, and perceptions of MAID's misalignment with healthcare. Those who were unsure (n = 45 [11%]) premised their responses on ambivalence and a lack of experience, both of which precluded formulating a definitive position.

Conclusion: Although three-quarters of participants were willing to be present during MAID, qualitative responses revealed great nuance within and across quantitative subsamples. Hospice clinicians would benefit from greater professional guidance and support pertaining to MAID.

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来源期刊
Palliative Care and Social Practice
Palliative Care and Social Practice Nursing-Advanced and Specialized Nursing
CiteScore
2.90
自引率
0.00%
发文量
37
审稿时长
9 weeks
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