METHODS: A qualitative, explorative research design with individual interviews was carried out based on a semi-open interview guide. A total of 6 doctors and 6 nurses working in medical or surgical departments at a Norwegian University hospital were interviewed. The interviews were analyzed using qualitative content analysis.
RESULTS: The study\'s findings highlight that recognizing and acknowledging patients with cancer as being at end-of-life is a challenging process. Three subthemes emerged from the analysis; the significance of being experienced, the significance of organizational structures, and the significance of having a common understanding. A main theme was analyzed further and abstracted from the subthemes; Being safe to manage the balancing act of recognizing and acknowledging the end of life.
CONCLUSIONS: Much is at stake in the EOL setting, and healthcare professionals (HCP) must balance several aspects regarding EOL decisions. Striking the right balance in these situations is challenging. HCPs need a safety net through collaboration with, and support from, colleagues, supporting organizational structures and experience. Strengthening the safety net will have a clear impact on improving clinical practice to reduce futile treatment and provide high-quality EOL care for all dying patients in hospitals.
方法:定性,基于半开放式访谈指南,进行了个人访谈的探索性研究设计。采访了挪威大学一家医院在内科或外科部门工作的6名医生和6名护士。访谈采用定性内容分析进行分析。
结果:这项研究的发现强调,识别和承认癌症患者处于生命终结状态是一个具有挑战性的过程。分析中出现了三个子主题;经历的意义,组织结构的重要性,以及共同理解的重要性。进一步分析了一个主要主题,并从子主题中抽象出来;安全地管理识别和承认生命终结的平衡行为。
结论:在EOL设置中存在很多风险,和医疗保健专业人员(HCP)必须平衡有关EOL决策的几个方面。在这些情况下取得适当的平衡是具有挑战性的。HCP需要通过与,和支持,同事们,支持组织结构和经验。加强安全网将对改善临床实践产生明显影响,以减少徒劳的治疗,并为医院中所有垂死的患者提供高质量的EOL护理。