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首页> 外文期刊>Archives of disease in childhood >Conflict escalation in paediatric services: findings from a qualitative study
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Conflict escalation in paediatric services: findings from a qualitative study

机译：儿科服务中的冲突升级：定性研究的结果

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Objective To explore clinician and family experiences of conflict in paediatric services, in order to map the trajectory of conflict escalation. Design Qualitative interview study, employing extreme-case sampling. Interviews were analysed using an iterative thematic approach to identify common themes regarding the experience and escalation of conflict. Participants Thirty-eight health professionals and eight parents. All participants had direct experience of conflict, including physical assault and court proceedings, at the interface of acute and palliative care. Setting Two teaching hospitals, one district general hospital and two paediatric hospices in England, in 2011. Results Conflicts escalate in a predictable manner. Clearly identifiable behaviours by both clinicians and parents are defined as mild, moderate and severe. Mild describes features like the insensitive use of language and a history of unresolved conflict. Moderate involves a deterioration of trust, and a breakdown of communication and relationships. Severe marks disintegration of working relationships, characterised by behavioural changes including aggression, and a shift in focus from the child's best interests to the conflict itself. Though conflicts may remain at one level, those which escalated tended to move sequentially from one level to the next. Conclusions Understanding how conflicts escalate provides clinicians with a practical, evidence-based framework to identify the warning signs of conflict in paediatrics.
机译：目的探讨儿科服务冲突中的临床医生和家庭经历，以绘制冲突升级的轨迹。设计定性访谈研究，采用极端案例抽样。使用迭代主题方法对访谈进行了分析，以找出有关冲突经验和冲突升级的共同主题。参与者38名卫生专业人员和8名父母。所有参与者都在急性和姑息治疗的交往中有直接的冲突经历，包括人身攻击和法庭诉讼。 2011年，在英国成立了两家教学医院，一家地区综合医院和两家儿童医院。结果冲突以可预测的方式升级。临床医生和父母都可以明确识别的行为定义为轻度，中度和严重。轻度描述了诸如语言不敏感使用和未解决的冲突历史之类的功能。中度会降低信任度，并破坏沟通和关系。严重标志着工作关系的瓦解，其特征是包括侵略行为在内的行为改变，以及从儿童的最大利益向冲突本身转移了注意力。尽管冲突可能仍停留在一个层次上，但逐步升级的冲突往往会从一个层次依次移至下一个层次。结论了解冲突如何升级为临床医生提供了一个实用的，循证的框架，以识别儿科冲突的警告信号。

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