Terminal Care Nursing in Pediatric Oncology and the Development of Nursing Protocols

本研究主要基于对57名护士访谈的扎根理论分析，描述了有经验的儿科护士在癌症晚期有孩子的家庭中扮演的角色。在临终阶段，护士不仅要照顾家庭的焦虑和不确定因素，同时还要努力引导家庭接受失去孩子的事实，并鼓励他们谨慎地做出决定。当一个孩子非常接近死亡的时候，护士们会努力创造一个“好死”的局面。他们通过确保所有适当的人都在现场，家庭成员能够与孩子进行身体接触，以及环境平静来做到这一点。护士评估她们在临终关怀情况下的表现，依据的是她们为“好的死亡”做好准备的情况。他们根据这一评估修改了他们对“好死”的概念。这样，他们就可以看到他们扮演着舞台导演的角色，按照他们的“好死”的概念来塑造局面。

Based mainly on grounded theory analysis of interviews with 57 nurses, this study describes what kind of roles experienced pediatric nurses take with families who have children in the terminal stages of cancer. During the terminal stage, the nurses not only work to take care of a family's anxieties and uncertainties, but at the same time try to lead the family toward accepting the fact that they are losing a child and encourage them to make their decisions carefully. When a child is very close to dying, the nurses try to create a "good death" situation. They do this by making sure that all the appropriate people are at the scene, that the family members are able to have physical contact with the child, and that the setting is calm. The nurses evaluate their performance in terminal care situations on the basis of how well they were able to prepare the conditions for a "good death". They modify their concept of a "good death" based on this evaluation. In this way, they could be seen a taking the role of a stage director, molding the situation according to their concept of a "good death".