Research progress of role function and experience in nurses’ communication in hospice care unit

doi:10.3761/j.issn.0254-1769.2021.07.023

Abstract

Abstract:

Hospice care emphasizes the comprehensive support for patients based on multidisciplinary cooperation mode. Nurses play an important role in coordinating the communication between the team and patients. This article summarizes the communication content,the role and function of nurses and the present situation of communication experience in hospice care unit. The role function is mainly the navigator,evaluator,educator and supporter,and the communication experience includes contradiction and restraint,negative feelings and positive influences. The enlightenment of improving the communication experience of nurses in hospice care unit is developed in order to provide references for nurses in hospice care to participate in ward communication in China.

Key words: Hospice Care, Nurse, Communication, Role, Experience, Review

摘要：

安宁疗护强调基于多学科协作模式对患者进行身心全方位支持,护士是安宁疗护团队的主要成员,在协调团队及患者沟通中发挥重要作用。该文综述了安宁疗护沟通内容、安宁疗护护士沟通中的角色功能及沟通体验,其中角色功能主要是导航者、评估者、教育者、支持者,沟通体验包括矛盾束缚、负性感受及积极影响,并针对性提出改善安宁疗护护士沟通体验的措施,以期为中国安宁疗护护士参与病房沟通提供借鉴。

关键词: 安宁疗护, 护士, 沟通, 角色, 体验, 综述

GAO Xinyi,CHEN Yiyang,WEN Hua,DONG Shiqi,TANG Han,CHEN Changying. Research progress of role function and experience in nurses’ communication in hospice care unit[J]. Chinese Journal of Nursing, 2021, 56(7): 1093-1097.

郜心怡,陈怡杨,温华,董诗奇,唐涵,陈长英. 安宁疗护护士沟通中角色功能及体验的研究进展[J]. 中华护理杂志, 2021, 56(7): 1093-1097.

References 43

[1]	中华人民共和国中央人民政府. 中共中央国务院印发《“健康中国2030”规划纲要》[EB/OL]. (2016-10-25)[2021-06-01]. http://www.gov.cn/xinwen/2016-10/25/content_5124174.htm.
	People’s Central Government of People’s Republic of China. POutline of “Healthy China 2030” Issued by the State Council of Central Committee of the Communist Party of China[EB/OL]. (2016-10-25)[2021-06-01]. http://www.gov.cn/xinwen/2016-10/25/content_5124174.htm.
[2]	国家卫生计生委. 国家卫生计生委关于印发全国护理事业发展规划（2016—2020年）的通知[EB/OL]. (2016-11-18)[2020-10-28]. https://www.nhc.gov.cn/yzygj/s3593/201611/92b2e8f8cc644 a899e9d0fd572aefef3.shtml
	The Health and Family Planning Commission of the People’s Republic of China. The Health and Family Planning Commission of the People’s Republic of China on printing and distributing the national nursing development plan（2016-2020）. (2016-11-18)[2020-10-28]. https://www.nhc.gov.cn/yzygj/s3593/201611/92b2e8f8cc644 a899e9d0fd572aefef3.shtml
[3]	Strachan PH, Kryworuchko J, Nouvet E, et al. Canadian hospital nurses’ roles in communication and decision-making about goals of care:an interpretive description of critical incidents[J]. Appl Nurs Res, 2018, 40:26-33. DOI URL
[4]	Ellington L, Clayton MF, Reblin M, et al. Communication among cancer patients,caregivers,and hospice nurses:content,process and change over time[J]. Patient Educ Couns, 2018, 101(3):414-421. DOI PMID
[5]	许湘华, 成琴琴, 王英, 等. 国外安宁疗护质量评估的研究进展[J]. 中华护理杂志, 2019, 54(10):1578-1583.
	Xu XH, Cheng QQ, Wang Y, et al. Research progress of oversea nursing assessment of quality of care for palliative care[J]. Chin J Nurs, 2019, 54(10):1578-1583.
[6]	Newman AR. Nurses’ perceptions of diagnosis and prognosis-related communication:an integrative review[J]. Cancer Nurs, 2016, 39(5):E48-E60. DOI URL
[7]	Newman AR, Haglund K, Rodgers CC. Pediatric oncology nurses’ perceptions of prognosis-related communication[J]. Nurs Outlook, 2019, 67(1):101-114. DOI PMID
[8]	吴际军, 林琴, 付梦雪, 等. 我国首批安宁疗护试点城市安宁疗护护士职业认同的现状调查[J]. 中华护理杂志, 2020, 55(8):1229-1233.
	Wu JJ, Lin Q, Fu MX, et al. Investigation on professional identity of hospice nurses[J]. Chin J Nurs, 2020, 55(8):1229-1233.
[9]	韩鸽鸽, 陈长英, 王盼盼, 等. 安宁疗护病房护士工作现状的质性研究[J]. 护理学杂志, 2020, 35(12):65-67.
	Han GG, Chen CY, Wang PP, et al. Qualitative study on work status of palliative care nurses[J]. J Nurs Sci, 2020, 35(12):65-67.
[10]	黄芳. 肿瘤科和安宁疗护医患沟通话语研究:国际期刊文献计量分析[J]. 外国语言文学, 2019, 36(1):44-59.
	Huang F. A bibliometric analysis of research in international journals on communication in oncology and palliative care[J]. Foreign Lang Lit, 2019, 36(1):44-59.
[11]	Thomas W, Leblanc JT. 肿瘤科和安宁疗护医患沟通话语研究:国际期刊文献计量分析[EB/OL]. (2020-03-03)[2020-06-04]. https://www.uptodate.com/contents/discuss-ing-goals-of-care
[12]	缪佳芮, 邓仁丽, 陈柳柳, 等. 预立医疗照护计划沟通要素:肿瘤科医务人员的视角[J]. 医学与哲学, 2018, 39(16):81-84.
	Miao JR, Deng RL, Chen LL, et al. Advance care planning communication elements:perspectives from oncology medical staff[J]. Med Philos, 2018, 39(16):81-84.
[13]	Koh SJ, Kim S, Kim J, et al. Experiences and opinions related to end-of-life discussion:from oncologists’ and resident physicians’ perspectives[J]. Cancer Res Treat, 2018, 50(2):614-623. DOI URL
[14]	McLennon SM, Lasiter S, Miller WR, et al. Oncology nurses’ experiences with prognosis-related communication with patients who have advanced cancer[J]. Nurs Outlook, 2013, 61(6):427-436. DOI PMID
[15]	Miller N, Rogers SN. A review of question prompt lists used in the oncology setting with comparison to the patient concerns inventory[J]. Eur J Cancer Care(Engl), 2018, 27(1):e12489.
[16]	李旭英, 谌永毅, 沈波涌, 等. 安宁疗护全人照护模式[J]. 中国护理管理, 2018, 18(z1):69-72.
	Li XY, Chen YY, Shen BY, et al. Holistic care model of hospice care[J]. Chin Nurs Manag, 2018, 18(z1):69-72.
[17]	Newman AR, Linder L, Haglund K. The nurse’s role in prognosis-related communication in pediatric oncology nursing practice[J]. J Pediatr Oncol Nurs, 2020, 37(5):313-320. DOI PMID
[18]	缪佳芮, 陈柳柳, 张江辉, 等. 晚期癌症患者预立医疗照护计划质性研究进展[J]. 医学与哲学, 2018, 39(2):61-64.
	Miao JR, Chen LL, Zhang JH, et al. Advances on qualitative research about advance care planning in patients with advanced cancer[J]. Med Philos, 2018, 39(2):61-64.
[19]	刘美, 王成爽, 王淑静, 等. 终末期癌症患者照顾者参与家庭会议体验的质性研究[J]. 护理学杂志, 2018, 33(24):5-7.
	Liu M, Wang CS, Wang SJ, et al. The experience of caregivers participating in terminal cancer patient’s family conferences-a qualitative study[J]. J Nurs Sci, 2018, 33(24):5-7.
[20]	Montgomery KE, Sawin KJ, Hendricks-Ferguson V. Communication during palliative care and end of life[J]. Cancer Nurs, 2017, 40(2):E47-E57. DOI URL
[21]	Reblin M, Clayton MF, Xu J, et al. Caregiver,patient,and nurse visit communication patterns in cancer home hospice[J]. Psy-chooncology, 2017, 26(12):2285-2293.
[22]	王粲霏, 贾会英, 吴珂, 等. 多学科协作模式在安宁疗护中的应用研究进展[J]. 中华护理杂志, 2018, 53(7):866-872.
	Wang CF, Jia HY, Wu K, et al. Progress on application of multidisciplinary collaboration in hospice care:a literature review[J]. Chin J Nurs, 2018, 53(7):866-872.
[23]	Head BA, Song MK, Wiencek C, et al. Palliative nursing summit[J]. J Hospice Palliat Nurs, 2018, 20(1):23-29. DOI URL
[24]	叶嘉慧, 杨智慧, 张立力. 肿瘤科医护人员对病人优逝认知的质性研究[J]. 护理研究, 2017, 31(18):2278-2283.
	Ye JH, Yang ZH, Zhang LL. Qualitative research on cognition of medical staff on good death of patients in department of oncology[J]. Chin Nurs Res, 2017, 31(18):2278-2283.
[25]	Sawin KJ, Montgomery KE, Dupree CY, et al. Oncology nurse managers’ perceptions of palliative care and end-of-life communication[J]. J Pediatr Oncol Nurs, 2019, 36(3):178-190. DOI URL
[26]	张清慧, 谌永毅, 陈偶英, 等. 安宁疗护中专业健康照护者哀伤情绪的研究进展[J]. 中华护理杂志, 2019, 54(12):1805-1809.
	Zhang QH, Chen YY, Chen OY, et al. Research progress on grief of professional caregivers in palliative care[J]. Chin J Nurs, 2019, 54(12):1805-1809.
[27]	Oh J, Dennis K, Lefresne S, et al. End-of-life discussions in practice:survey among Canadian radiation oncologists[J]. Ann Palliat Med, 2019, 8(4):420-427. DOI URL
[28]	赵敬, 张艳, 王昱, 等. 安宁疗护试点病房护士工作体验研究[J]. 护理学杂志, 2020, 35(11):56-59.
	Zhao J, Zhang Y, Wang Y, et al. Work experience of nurses working in a pilot ward for hospice care[J]. J Nurs Sci, 2020, 35(11):56-59.
[29]	董毅, 李玲. 医院伦理氛围与护士临终关怀态度的相关性研究[J]. 护理学杂志, 2020, 35(18):90-92.
	Dong Y, Li L. Relationship between hospital ethical climate and nurses’ attitude toward care of the dying[J]. J Nurs Sci, 2020, 35(18):90-92.
[30]	程秀丽, 成芳. 安心茶话屋在肿瘤科护士死亡教育中的应用[J]. 中华护理杂志, 2019, 54(12):1777-1781.
	Cheng XL, Cheng F. The practice of Heart to Heart Café in death education of oncology nurses[J]. Chin J Nurs, 2019, 54(12):1777-1781.
[31]	Curtis JR, Downey L, Back AL, et al. Effect of a patient and clinician communication-priming intervention on patient-reported goals-of-care discussions between patients with serious illness and clinicians:a randomized clinical trial[J]. JAMA Intern Med, 2018, 178(7):930-940. DOI URL
[32]	You JJ, Downar J, Fowler RA, et al. Barriers to goals of care discussions with seriously ill hospitalized patients and their families[J]. JAMA Intern Med, 2015, 175(4):549. DOI URL
[33]	李宝兰, 胡瑛. 与晚期癌症患者及其家属进行有效沟通的尝试及思考[J]. 中国医学伦理学, 2015, 28(6):948-950.
	Li BL, Hu Y. Discussion of the effective communication to advanced cancer patients and their families[J]. Chin Med Ethics, 2015, 28(6):948-950.
[34]	罗春梅, 罗羽, 徐霞, 等. 六步癌症告知模型的应用研究进展[J]. 中华护理杂志, 2019, 54(1):114-118.
	Luo CM, Luo Y, Xu X, et al. Training and application of Six-Step Protocol model for cancer information disclosure:a review[J]. Chin J Nurs, 2019, 54(1):114-118.
[35]	王莉莉, 顾则娟, 杜艳鸣, 等. SHARE沟通模式在乳腺癌患者病情告知中的应用[J]. 中国护理管理, 2019, 19(12):1827-1832.
	Wang LL, Gu ZJ, Du YM, et al. Application of SHARE communication model in the notification of breast cancer patients[J]. Chin Nurs Manag, 2019, 19(12):1827-1832.
[36]	Childers JW, Back AL, Tulsky JA, et al. REMAP:a framework for goals of care conversations[J]. J Oncol Pract, 2017, 13(10):e844-e850. DOI URL
[37]	Wittenberg E, Reb A, Kanter E. Communicating with patients and families around difficult topics in cancer care using the COMFORT communication curriculum[J]. Semin Oncol Nurs, 2018, 34(3):264-273. DOI PMID
[38]	Wittenberg E, Ferrell B, Goldsmith J, et al. COMFORT^TM SM communication for oncology nurses:program overview and preliminary evaluation of a nationwide train-the-trainer course[J]. Patient Educ Couns, 2018, 101(3):467-474. DOI PMID
[39]	丁浩. 结构家庭治疗模式介入城市隔代抚养家庭代际冲突问题的研究:以Y市A家庭个案研究为例[D]. 武汉:华中科技大学, 2019.
	Ding H. Research on the intervention of structural family therapy model in intergenerational conflict of urban intergenerational raising families[D]. Wuhan:Huazhong University of Science and Technology, 2019.
[40]	吴洪寒. 基于MDT构建癌症患者安宁疗护模式的研究[D]. 南京:南京中医药大学, 2020.
	Wu HH. Study on the construction of hospice care model for cancer patients based on MDT[D]. Nanjing:Nanjing University of Traditional Chinese Medicine, 2020.
[41]	Tang ST, Chen JS, Wen FH, et al. Advance care planning improves psychological symptoms but not quality of life and preferred end-of-life care of patients with cancer[J]. J Natl Compr Canc Netw, 2019, 17(4):311-320. DOI URL
[42]	Chen CH, Chen JS, Wen FH, et al. An individualized,interactive intervention promotes terminally ill cancer patients’ prognostic awareness and reduces cardiopulmonary resuscitation received in the last month of life：secondary analysis of a randomized clinical trial[J]. J Pain Symptom Manage, 2019, 57(4):705-714.e7. DOI URL
[43]	何文奇, 陈长英, 杜若飞, 等. 癌症临终患者医患间沟通影响因素及干预的研究进展[J]. 中华护理杂志, 2018, 53(12):1509-1513.
	He WQ, Chen CY, Du RF, et al. Affecting factors and interventions of end-of-life communication between cancer patients and healthcare professionals:a review[J]. Chin J Nurs, 2018, 53(12):1509-1513.