Grief symptoms and difficult patient loss for oncologists in response to patient death
Grief symptoms and difficult patient loss for oncologists in response to patient death
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DOI：
10.1002/pon.4118
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发表时间：
2017-07-01
期刊：
影响因子：
3.6
通讯作者：
Ariad, Samuel
中科院分区：
文献类型：
--
作者：
Granek, Leeat;Ben-David, Merav;Ariad, Samuel
目的本研究旨在探讨肿瘤医生对患者死亡的悲伤症状，并确定患者死亡时，哪些损失特别具有挑战性。方法采用扎根理论方法进行资料收集和分析。在2013年3月至2014年6月期间，来自以色列北部、中部和南部三个成人肿瘤中心的22名肿瘤学家接受了采访。肿瘤学家处于职业生涯的不同阶段，他们的子专业、性别、个人和专业背景各不相同。结果：当患者死亡时，预期患者死亡时，死亡后许多天，或患者预后不良时，悲伤开始。肿瘤学家的悲伤现象学经验包括对患者死亡的行为、认知、身体和情绪症状。行为症状包括哭泣和睡眠困难。认知症状包括自我怀疑和对患者以及患者生前接受的护理的反思。身体症状包括胸痛、疲劳和全身不适。情绪症状包括悲伤、焦虑、无助、内疚、解脱、易怒和失落。造成患者难失的因素有患者相关因素、家庭相关因素和疾病相关因素。结论患者死亡可导致肿瘤科医生出现行为、认知、身体和情绪上的悲伤症状。这些症状在患者、家庭和疾病相关因素的背景下变得特别强烈。为了支持肿瘤学家在情感和精神上繁重的工作，需要对与患者死亡有关的悲伤进行管理的教育和支持性干预。版权所有：John Wiley & Sons， Ltd。
ObjectiveThe study aimed to explore oncologist's grief symptoms over patient death and to identify why and which losses are particularly challenging when patients die.MethodsThe grounded theory method was used to collect and analyze the data. Twenty-two oncologists were interviewed between March 2013 and June 2014 from three adult oncology centers in the north, center, and south of Israel. Oncologists were at different stages of their careers and varied in their sub-specialties, gender, and personal and professional backgrounds.ResultsGrief begun when the patient died, in anticipation of the patient's death, many days after the death, or when the patient received a poor prognosis. The phenomenological experience of grief for oncologists included behavioral, cognitive, physical, and emotional symptoms in response to patient death. Behavioral symptoms included crying and difficulties sleeping. Cognitive symptoms included self-doubt and rumination about the patient and the care the patient had received before death. Physical symptoms included chest pain, fatigue, and general physical discomfort. Emotional symptoms included sadness, anxiety, helplessness, guilt, relief, irritability, and loss. Difficult patient loss was caused by patient-related factors, family-related factors, and disease-related factors.ConclusionsPatient deaths result in behavioral, cognitive, physical, and emotional symptoms of grief in oncologists. These symptoms become particularly intense in the context of patient, family, and disease-related factors. Educational and supportive interventions for managing grief related to patient death are needed in order to support oncologists in their emotionally and mentally taxing work. Copyright (c) 2016 John Wiley & Sons, Ltd.