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首页> 外文期刊>The American journal of hospice and palliative care >Identifying barriers to psychosocial spiritual care at the end of life: a physician group study.
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Identifying barriers to psychosocial spiritual care at the end of life: a physician group study.

机译：确定生命终结时进行社会心理精神护理的障碍：医师小组研究。

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OBJECTIVE: The recent literature addresses the need to improve care for dying patients. The purpose of this study was to identify barriers to the psychosocial spiritual care of these patients by their physicians. Psychosocial spiritual care is defined as aspects of care concerning patient emotional state, social support and relationships, and spiritual well-being. The study was an exploratory means for generating hypotheses and identifying directions for interventions, research, and training in care for the dying. DESIGN AND PARTICIPANTS: The study used a qualitative group discussion format. Seventeen physicians at a university-based health sciences center representing 10 areas of medical specialty--including internal medicine, oncology, pediatrics, and geriatrics met in two groups for 20 75-minute discussion sessions over the course of one year. Discussions were recorded, analyzed, and categorized. RESULTS: Barriers to psychosocial spiritual care were grouped into three domains and seven themes. The cultural domain included the themes of training, selection, medical practice environment, and debt/delay. Participants believed that medical selection and training combine to marginalize psychosocial spiritual approaches to patient care, while the practice environment and debt/delay augment emotional isolation and dampen idealism. The organizational domain included the themes of dissatisfaction and time/busyness. Physicians indicated that the current reimbursement climate and time pressures contribute to dissatisfaction and the tendency to avoid patient psychosocial spiritual issues. The clinical domain included the theme of communication. Physicians were concerned about their ability to communicate nonmedical issues effectively and manage the patient s reactions and needs in the psychosocial spiritual arena. CONCLUSIONS: This study suggests that research and educational approaches to improving the psychosocial spiritual care of the dying by physicians should address barriers at the cultural, organizational, and clinical levels. Suggestions for interventions at various levels are offered.
机译：目的：最近的文献提出了改善垂死患者护理的需求。这项研究的目的是确定医师对这些患者进行心理社会精神护理的障碍。心理社会精神护理定义为与患者的情绪状态，社会支持和关系以及精神健康有关的护理方面。这项研究是一种探索性方法，可用于产生假设并确定干预措施，研究和护理垂死者的方向。设计和参与者：该研究采用定性的小组讨论形式。总部位于大学的健康科学中心的17位医生代表了10个医学专业领域-包括内科，肿瘤学，儿科和老年医学，在一年的过程中分两组进行了20次75分钟的讨论。对讨论进行记录，分析和分类。结果：心理社会精神护理的障碍分为三个领域和七个主题。文化领域包括培训，甄选，医疗实践环境以及债务/延误等主题。参加者认为，医疗选择和培训相结合会边缘化心理社会精神方法来护理患者，而实践环境和债务/延误则加剧了情感隔离并挫败了理想主义。组织领域包括不满和时间/忙碌的主题。医师表示，目前的报销气候和时间压力会导致不满，并有避免患者心理社会精神问题的趋势。临床领域包括交流主题。医生担心他们在心理社会精神领域有效沟通非医学问题并管理患者反应和需求的能力。结论：这项研究表明，研究和教育方法应改善医师对垂死者的心理社会精神保健，应解决文化，组织和临床层面的障碍。提供了各种干预措施的建议。

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