Communication Behaviors and Patient and Caregiver Emotional Concerns: A Description of Home Hospice Communication
Communication Behaviors and Patient and Caregiver Emotional Concerns: A Description of Home Hospice Communication
复制标题
DOI：
10.1188/14.onf.311-321
复制
发表时间：
2014-05-01
影响因子：
1.9
通讯作者：
Ellington, Lee
中科院分区：
文献类型：
--
作者：
Clayton, Margaret F.;Reblin, Maija;Ellington, Lee
目的/目标：识别和描述临终关怀护士在引发和解决癌症患者及其照顾者的担忧时所使用的沟通行为。设计：二次分析。设置：湖城的家庭临终关怀。样本：来自七名患者和照顾者的录音和五名临终关怀护士。方法：使用Roter互动分析系统对患者和护理人员的音频记录进行编码，这些音频记录表明负面影响和痛苦，周边护士沟通行为。关注的内容进行了分类，使用域开发的全国共识项目质量姑息治疗。主要研究变量：患者和护理人员的关注声明和护士的沟通behaviors.Findings：180患者和护理人员的发言轮流包含的关注，确定在31临终关怀访问。在绝大多数访问中，患者和护理人员至少表达了一种担忧。最普遍的痛苦领域反映了心理和身体问题。护士使用比例更积极的情感陈述之前，病人和照顾者的关注，相比，整体访问。护士在关注陈述后询问更多的身体问题。护士也使用了更多的情绪反应之前和之后的病人和照顾者的关注，相对于整个visit.Conclusions：癌症患者和照顾者经常谈论令人痛苦的问题。临终关怀护士使用特定的沟通行为来引发和解决这些问题。对护理的影响：家庭临终关怀提供了一个场所，以检查护士的沟通行为，用于引发和回应病人和照顾者的痛苦。这些策略可以教给那些不太经常遇到病人痛苦或不太适应情绪化谈话的护士。
Purpose/Objectives: To identify and describe communication behaviors used by hospice nurses when eliciting and addressing concerns of patients with cancer and their caregivers.Design: Secondary analysis.Setting: Home hospice in Salt Lake City, UT.Sample: Audio recordings from seven patient and caregiver dyads and five hospice nurses.Methods: Audio recordings were coded using the Roter Interaction Analysis System for patient and caregiver concern statements indicating negative affect and distress and the surrounding nurse communication behaviors. Concern content was categorized using domains developed by the National Consensus Project for Quality Palliative Care.Main Research Variables: Patient and caregiver concern statements and nurse communication behaviors.Findings: 180 patient and caregiver speaking turns containing concerns were identified across 31 hospice visits. Patients and caregivers expressed at least one concern in the vast majority of visits. The most prevalent distress areas reflected psychological and physical issues. Nurses used proportionally more positive emotion statements before patient and caregiver concerns, compared to the visit overall. Nurses asked proportionally more physical questions after concern statements. Nurses also used more emotional responses before and after patient and caregiver concerns, relative to the entire visit.Conclusions: Patients with cancer and caregivers frequently talk about distressing issues. Hospice nurses use specific communication behaviors to elicit and address those issues.Implications for Nursing: Home hospice provides a venue to examine nurse communication behaviors used to elicit and respond to patient and caregiver distress. These strategies could be taught to nurses who encounter patient distress less frequently or are less comfortable with emotional conversations.