目的:心肺复苏(CPR)是一种特殊的身体状况,可能导致重大的心理,精神,以及患者及其近亲的社会困扰。此外,临床医生可能会遇到与CPR事件相关的痛苦.专科姑息治疗(sPC)整合可以解决这些方面,但不是常规护理的一部分。
目的:本研究旨在探讨CPR期间和之后sPC整合的观点。对SPC的需求评估,可能的触发器表明需要,并制定了实施战略。
方法:在德国城市学术教学医院进行了一项多专业定性半结构化焦点小组研究。参与者是临床医生(护理人员,居民,和顾问)在急诊科和ICU(内科和外科)工作。
方法:记录焦点组,随后进行转录。根据Kuckartz使用内容结构化内容分析来分析数据材料。
结果:从2022年7月至11月在线进行了7个焦点小组,共有18名参与者。确定了六个主要类别(两到五个子类别):理解(姑息治疗和死亡),一般心肺复苏状况(例如,团队,汇报,和菌株),预后(例如,预先存在的情况,使用体外支持),近亲(例如,通信,CPR期间的存在),治疗计划(患者意愿和决策),和sPC的实现(例如,定时,触发因素)。
结论:关于CPR期间和之后需要sPC支持的看法取决于角色,实践领域,以及个人对SPC的理解。尽管一些参与者认为心肺复苏术本身是sPC的触发因素,其他人定义,例如,CPR前存在的多发病率或复杂的家庭动态可能的触发因素。实施建议是多方面的,特别是强调sPC的沟通。需要进一步探讨体外CPR的具体挑战。总的来说,焦点小组表明该主题被认为是相关的,对结果的研究是有必要的。
OBJECTIVE: Cardiopulmonary resuscitation (CPR) is an exceptional physical situation and may lead to significant psychological, spiritual, and social distress in patients and their next of kin. Furthermore, clinicians might experience distress related to a CPR event. Specialist palliative care (sPC) integration could address these aspects but is not part of routine care.
OBJECTIVE: This study aimed to explore perspectives on sPC integration during and after CPR. A needs assessment for sPC, possible triggers indicating need, and implementation strategies were addressed.
METHODS: A multiprofessional qualitative semistructured focus group study was conducted in a German urban academic teaching hospital. Participants were clinicians (nursing staff, residents, and consultants) working in the emergency department and ICUs (internal medicine and surgical).
METHODS: The focus groups were recorded and subsequently transcribed. Data material was analyzed using the content-structuring content analysis according to Kuckartz.
RESULTS: Seven focus groups with 18 participants in total were conducted online from July to November 2022. Six main categories (two to five subcategories) were identified: understanding (of palliative care and death), general CPR conditions (e.g., team, debriefing, and strains), prognosis (e.g., preexisting situation, use of extracorporeal support), next of kin (e.g., communication, presence during CPR), treatment plan (patient will and decision-making), and implementation of sPC (e.g., timing, trigger factors).
CONCLUSIONS: Perceptions about the need for sPC to support during and after CPR depend on roles, areas of practice, and individual understanding of sPC. Although some participants perceive CPR itself as a trigger for sPC, others define, for example, pre-CPR-existing multimorbidity or complex family dynamics as possible triggers. Suggestions for implementation are multifaceted, especially communication by sPC is emphasized. Specific challenges of extracorporeal CPR need to be explored further. Overall, the focus groups show that the topic is considered relevant, and studies on outcomes are warranted.