Gianluca Catania, Michela Calzolari, Milko Zanini, Paola Pilastri, Patrizia Borsellino, Lorena Forni, Camilla Guglielmelli, Melanie Valera, Silvia Marenco, Michele Gallucci, Bruno Cavaliere, Roberta Rapetti, Marco Di Nitto, Loredana Sasso, Annamaria Bagnasco
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Physicians, nurses, or nursing assistants who worked in the oncohematology, internal medicine, intermediate care, surgical areas, or hospices of three hospitals in the northwest of Italy were included. All participants were included if they agreed to participate in the study and signed a written informed consent. A modified version of the guide \"Your Conversation Starter Kit,\" the ConVita Questionnaire, was used. A logistic regression to analyze possible associations between personal and professional characteristics and end-of-life wishes of healthcare professionals was performed.</p><p><strong>Results: </strong>Of the 747 professionals who agreed to participate, 467 questionnaires were returned. Compared to physicians, nurses (OR = 2.551 [95% CI 1.306-4.982], P = .006) and nursing assistants (OR = 2.755 [95% CI 1.218-6.23], P = .015) were more likely to prefer receiving treatments regardless the discomfort these might cause. This was less likely to occur when professionals attended palliative care courses (OR = 0.655 [95% CI 0.431-0.997], P = .048). Professionals with longer working experience in the same unit were more likely to give more importance to the quality of life than to the amount of medical care (OR = 1.041 [95% CI 1.006-1.078], P = .022). Compared to physicians, nurses were more likely to worry about not receiving sufficient treatments (OR = 2.883 [95% CI 1.526-5.446], P = .001).</p><p><strong>Conclusions: </strong>This study contributes to a better understanding of healthcare professionals' wishes if they were in the hypothetical condition of end of life. Healthcare professionals need support to gain insight into end-of-life issues.</p><p><strong>Implication for nursing practice: </strong>By better understanding healthcare professionals' perspective on end of life, this study may help build the support they need to feel better equipped to address end-of-life conversations with patients and families. 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引用次数: 0
摘要
目的生命末期谈话可以改善患者及其家属的焦虑、抑郁和生活质量。大多数患者认为与医护人员讨论预后很重要,但只有少数患者表示会这样做。本研究旨在描述医护人员在假设生命末期的情况下对生命末期的愿望:在这项描述性相关研究中,采用普查抽样法选出了 467 名医护人员。研究对象包括在意大利西北部三家医院的血液内科、内科、中级护理、外科或临终关怀机构工作的医生、护士或护理助理。所有参与者只要同意参与研究并签署书面知情同意书,均被纳入研究范围。研究使用了 "您的对话启动工具包 "指南的修订版 ConVita 问卷。研究人员对医护人员的个人和职业特征与临终意愿之间可能存在的关联进行了逻辑回归分析:结果:在同意参与的 747 名专业人员中,共收回 467 份问卷。与医生相比,护士(OR = 2.551 [95% CI 1.306-4.982],P = .006)和护理助理(OR = 2.755 [95% CI 1.218-6.23],P = .015)更倾向于接受治疗,而不考虑这些治疗可能带来的不适。而参加过姑息关怀课程的专业人员则更少出现这种情况(OR = 0.655 [95% CI 0.431-0.997], P = .048)。在同一单位工作时间较长的专业人员更重视生命质量,而不是医疗护理的数量(OR = 1.041 [95% CI 1.006-1.078],P = .022)。与医生相比,护士更有可能担心得不到足够的治疗(OR = 2.883 [95% CI 1.526-5.446], P = .001):本研究有助于更好地了解医护人员在生命末期的假设情况下的愿望。医护人员需要得到支持,以深入了解临终问题:通过更好地了解医护人员对生命终结的看法,这项研究可能有助于为他们提供所需的支持,使他们能够更好地与病人和家属进行生命终结对话。姑息关怀课程可以提高医护人员的意识,以便及时开始临终对话。
Healthcare Professionals' Wishes Toward End-of-Life Conversations: A Descriptive Correlational Study (ConVita Study).
Objective: End-of-life conversations could improve anxiety, depression, and quality of life of patients and their families. Most patients believe it is important to discuss prognosis with their healthcare professionals, however only a minority reports to do so. The aim of this study was to describe healthcare professionals' wishes regarding end-of-life if they were in hypothetical end-of-life condition.
Methods: In this descriptive-correlational study, 467 healthcare providers were selected using the census sampling method. Physicians, nurses, or nursing assistants who worked in the oncohematology, internal medicine, intermediate care, surgical areas, or hospices of three hospitals in the northwest of Italy were included. All participants were included if they agreed to participate in the study and signed a written informed consent. A modified version of the guide "Your Conversation Starter Kit," the ConVita Questionnaire, was used. A logistic regression to analyze possible associations between personal and professional characteristics and end-of-life wishes of healthcare professionals was performed.
Results: Of the 747 professionals who agreed to participate, 467 questionnaires were returned. Compared to physicians, nurses (OR = 2.551 [95% CI 1.306-4.982], P = .006) and nursing assistants (OR = 2.755 [95% CI 1.218-6.23], P = .015) were more likely to prefer receiving treatments regardless the discomfort these might cause. This was less likely to occur when professionals attended palliative care courses (OR = 0.655 [95% CI 0.431-0.997], P = .048). Professionals with longer working experience in the same unit were more likely to give more importance to the quality of life than to the amount of medical care (OR = 1.041 [95% CI 1.006-1.078], P = .022). Compared to physicians, nurses were more likely to worry about not receiving sufficient treatments (OR = 2.883 [95% CI 1.526-5.446], P = .001).
Conclusions: This study contributes to a better understanding of healthcare professionals' wishes if they were in the hypothetical condition of end of life. Healthcare professionals need support to gain insight into end-of-life issues.
Implication for nursing practice: By better understanding healthcare professionals' perspective on end of life, this study may help build the support they need to feel better equipped to address end-of-life conversations with patients and families. Palliative care courses may raise healthcare professionals' awareness toward a timely start of end-of-life conversations.
期刊介绍:
Seminars in Oncology Nursing is a unique international journal published six times a year. Each issue offers a multi-faceted overview of a single cancer topic from a selection of expert review articles and disseminates oncology nursing research relevant to patient care, nursing education, management, and policy development.