当直接的患者护理优先时,定位伦理:在儿童癌症护理中实施伦理案例反思轮的经验
Pernilla Pergert1,2, Bert Molewijk3,4, Cecilia Bartholdson5,6
1Childhood Cancer Research Unit, Department of Women's & Children's Health, Karolinska Institutet, Stockholm, Sweden. pernilla.pergert@uu.se.
概括
在儿童癌症护理中的医疗保健专业人员发现实施道德案例反思 (ECR) 轮是具有挑战性的. 将伦理反思纳入标准护理中对于伦理能力至关重要,尽管优先考虑直接的患者护理.
科学领域:
- 医学伦理 医学伦理
- 儿科瘤学 儿科瘤学
- 定性研究是指质量研究.
背景情况:
- 照顾患有癌症的儿童面临着重大的伦理挑战.
- 伦理案例反思 (ECR) 轮为医疗保健团队提供了一种结构化的方法,以讨论和解决患者护理中的伦理困境.
- 一个北欧工作组为儿童瘤学ECR辅导员开发了一门培训课程.
研究的目的:
- 探索参加培训课程并随后在临床实践中实施道德案例反思 (ECR) 轮的医疗保健专业人员 (HCP) 的经验.
- 了解将ECR轮融入儿童癌症护理机构的日常工作流程中的挑战和促进者.
主要方法:
- 使用经典基础理论进行定性研究.
- 通过3次重点小组采访 (n=22) 和27次个人采访 (n=17) 收集与HCP学员的数据.
- 与数据收集并行进行数据分析.
主要成果:
- "定位伦理学"成为核心类别,反映了在专注于直接患者护理的背景下优先考虑伦理学的挑战.
- 伦理反思的时间往往被认为是奢品,而不是临床优先事项.
- "定位伦理"的成功策略包括结盟,促进,安排和识别伦理困境,有效性各不相同.
结论:
- 该研究强调了需要质疑直接患者护理和道德反思之间的两极分化.
- 将伦理反思纳入标准护理中,对于提高儿科瘤学伦理能力至关重要.
- 需要进一步的研究,以促进在实践和卫生保健人员的教育道德能力.
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