GPs' views concerning spirituality and the use of the FICA tool in palliative care in Flanders: a qualitative study
GPs' views concerning spirituality and the use of the FICA tool in palliative care in Flanders: a qualitative study
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DOI：
10.3399/bjgp12x656865
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发表时间：
2012-10-01
影响因子：
5.9
通讯作者：
Aertgeerts, Bert
中科院分区：
文献类型：
--
作者：
Vermandere, Mieke;Choi, Yoo-Na;Aertgeerts, Bert
背景：根据最近的建议，姑息治疗的医疗保健专业人员应该能够进行精神史。以前的研究结果表明，FICA工具是可行的灵性的临床评估。然而，鲜为人知的是关于使用此tool.Aim的全科医生的意见：提供一个坚实的概述佛兰芒全科医生的意见，关于灵性和使用的FICA工具的精神历史，采取姑息治疗。设计和设置：定性访谈研究在弗兰德斯，比利时。方法：二十三个全科医生参加了半结构化的采访。访谈进行了专题分析，其中包括逐行编码和生成的描述性和分析性themes.Results：受访者表示，他们会记住的FICA工具的问题，而有一个精神对话，但不使用它们作为一个检查表。该工具的内容被普遍认为是相关的，但是，许多全科医生认为该工具过于结构化和规定化，限制了他们的自发性。他们建议把这些问题改写成口语。在精神对话中，感知到的障碍包括不适和恐惧的感觉，以及缺乏时间和具体培训。促进精神对话的因素包括患者接受他们的诊断，信任的关系，并尊重患者的believs.Conclusion：一个姑息治疗的过程中，注意力集中在病人的灵性一般被认为是一个坚韧的，但有益的经验。该研究的结论是，FICA工具可能是一个可行的工具，精神的临床评估，提供了一定的实质性和语言的调整。需要更多的研究来找到最合适的精神历史记录模式，以满足全科医生的具体需求。
Background:According to recent recommendations, healthcare professionals in palliative care should be able to perform a spiritual history-taking. Previous findings suggest that the FICA tool is feasible for the clinical assessment of spirituality. However, little is known about the views of GPs on the use of this tool.Aim:To provide a solid overview of the views of Flemish GPs concerning spirituality and the use of the FICA tool for spiritual history-taking in palliative care.Design and setting:Qualitative interview study in Flanders, Belgium.Method:Twenty-three GPs participated in a semi-structured interview. The interviews were analysed by thematic analysis, which includes line-by-line coding and the generation of descriptive and analytical themes.Results:The interviewees stated that they would keep in mind the questions of the FICA tool while having a spiritual conversation, but not use them as a checklist. The content of the tool was generally appreciated as relevant, however, many GPs found the tool too structured and prescribed, and that it limited their spontaneity. They suggested rephrasing the questions into spoken language. The perceived barriers during spiritual conversations included feelings of discomfort and fear, and the lack of time and specific training. Factors that facilitated spiritual conversations included the patients' acceptance of their diagnosis, a trusting relationship, and respect for the patients' beliefs.Conclusion:A palliative care process with attention focused on the patient's spirituality was generally perceived as a tough but rewarding experience. The study concludes that the FICA tool could be a feasible instrument for the clinical assessment of spirituality, provided that certain substantive and linguistic adjustments are made. Additional research is needed to find the most suitable model for spiritual history-taking, in response to the specific needs of GPs.