Communication problems and conflicts in palliative care. An explorative research project to improve the quality of care at the end of life.

对危重病人和垂死病人的护理最好是建立在病人、家属和专业护士之间的密切和信任的关系上。然而，现实往往以不同的伦理、沟通或人际冲突为特征，这给所有受影响的各方带来了额外的压力来源。该项目分为两个部分，旨在探索和分析这些冲突情况及其在不同护理背景下的因果关系(即。医院、养老院、姑息治疗、临终关怀、残疾人设施和门诊护理)，并随后制定有针对性和科学合理的解决方案。为了找出有问题的情况，选择了有条不紊的探索性方法。分析了个人经历的个人评论和描述，以及患者和家属(N=74)对专业护士的期望。定性数据的收集是通过录像访谈进行的，随后进行内容分析。首先，特征发现允许模范面谈序列被削减，并作为与专业护士讨论的基础(N=24)。这些护士被要求参加焦点小组，以便提出他们的评估和可能的解决方案。对收集的数据的分析有助于确定姑息治疗中冲突的中心层面，并特别注意不同的环境(死亡地点)。该研究项目在奥斯纳布吕克和海德堡进行，为期24个月。根据这两个合作伙伴的结果，根据DFG的定义，打算通过调查结果转移项目为专业护士制定、实施和评估可持续的专业培训。

Care of critically ill and dying people is ideally based on a close and trustful relation between patients, family members, and professional nurses. Realities, however, are more often than not characterised by diverse ethical, communicative, or interpersonal conflicts, which present an additional source of strain for all affected parties. The project is divided in two parts and aims to explore and analyse these situations of conflict and their causal relations in different contexts of care (viz. hospitals, retirement homes, palliative care, hospices, facilities for the handicapped, and outpatient care) and to subsequently develop targeted and scientifically sound solutions. In order to identify problematic situations a methodically explorative approach is chosen. Personal remarks and depictions of individual experiences as well as expectations of patients and family members (N=74) towards professional nurses are analyzed. Qualitative data collection is conducted though videotaped interviews, which is successively subjected to content analysis. First characteristic findings then allow for exemplary interview sequences to be cut and used as a basis for discussions with professional nurses (N=24). These nurses are asked to participate in focus groups in order to present their assessment and propose possible solutions. An analysis of the collected data helps to identify central dimensions of conflict in palliative care with special attention to the different settings (places of death). The research project is conducted over a period of 24 months at Osnabrueck and Heidelberg. Based on the results of both partners, the development, implementation, and evaluation of a sustainable professional training for professional nurses through a findings-transfer project, as defined by the DFG, is intended.