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首页> 外文期刊>Palliative medicine >Issues in prognostication for hospital specialist palliative care doctors and nurses: A qualitative inquiry
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Issues in prognostication for hospital specialist palliative care doctors and nurses: A qualitative inquiry

机译：医院专科姑息治疗医生和护士的预后问题：质性研究

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Background: Patients with advanced life-limiting diseases have high information needs concerning prognosis yet discussions between patients and healthcare professionals are either avoided or inaccurate due to over-optimism. Available prognostic models are problematic. Literature indicates that hospital specialist palliative care professionals are frequently asked to prognosticate, although their experience of prognostication is unknown. Identifying this experience will support the development of prognosis training for hospital specialist palliative care professionals. Aim: To explore hospital specialist palliative care professionals' experience of prognostication. Research questions: 'How do specialist palliative care team members prognosticate?'; 'How do they view prognostication?' Design: Qualitative research focus group interviews. Setting/participants: Three UK hospital specialist palliative care teams. Participants included medical doctors and palliative care nurses. Inclusion/exclusion criteria: member of hospital specialist palliative care team with knowledge and experience of prognostication. Numbers of participants: four hospital specialist palliative medicine consultants, three senior doctors in training, nine clinical nurse specialists. Results: Two major themes: Difficulties of prognostication; Benefits of prognostication. Eleven sub-themes: Difficulties (Non-malignant disease; Communicating uncertainty; Seeking definitive prognosis; Participants' feelings; Confidence in prognostication; Estimating prognosis; Dealing with reaction of prognosis; Prognostic error); Benefits (Patient informed decision-making prioritizing needs and care; Family-prioritizing commitments; Services accessing funding and services planning patient care). Conclusions: Findings highlight lack of evidence to support practice, and identify the complexity and emotional labour involved in prognostication by hospital specialist palliative care team members, and are used to discuss recommendations for further research and practice.
机译：背景：患有严重生命受限疾病的患者对预后的信息需求很高，但由于过分乐观，因此避免了患者与医护人员之间的讨论或不准确的讨论。可用的预后模型存在问题。文献表明，尽管他们的预后经验尚不清楚，但经常要求医院专职姑息治疗专业人员进行预后。识别这种经验将支持对医院专家姑息治疗专业人员进行预后培训。目的：探讨医院专科姑息治疗专业人员的预后经验。研究问题：“姑息治疗专家小组成员如何进行预后？”;他们如何看待预后？设计：定性研究焦点小组访谈。机构/参与者：三个英国医院专家姑息治疗小组。参加者包括医生和姑息治疗护士。纳入/排除标准：医院专家姑息治疗团队的成员，他们具有预后的知识和经验。参加人数：四名医院专科姑息医学顾问，三名受过培训的高级医生，九名临床护士专家。结果：两个主要主题：预后的困难;预后的好处。十一个子主题：困难（非恶性疾病;沟通不确定性;寻求确定的预后;参与者的感受;对预后的信心;估计预后;处理预后的反应;预后的错误）;收益（患者知情的决策优先考虑需求和护理;家庭优先考虑的承诺;获得资金的服务和规划患者护理的服务）。结论：研究结果突出表明缺乏证据支持实践，并确定了医院专家姑息治疗团队成员参与预后的复杂性和情感劳动，并被用于讨论进一步研究和实践的建议。

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