坏消息和医生护理的成本:一个系统的范围审查
Cheng Yat Tan1, Nicholas Wei Hong Thum1, Trivikram Mohan2
1Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
BMJ supportive & palliative care
|January 28, 2026
概括
突破坏消息 (BBN) 影响医生的专业身份 (PIF) 形成,并承担个人护理成本. 建议采用以团队为基础的方法和整体培训来减轻这些影响.
科学领域:
- 医学教育 医学教育
- 医生福利 医生福利
- 在医疗保健领域的沟通
背景情况:
- 照顾临死亡的患者和痛苦的家庭对医生来说是创伤性的,影响了专业身份形成 (PIF).
- 在这些充满情绪的遭遇中,缺乏足够的支持可能会对患者的护理,家庭支持和团队合作产生负面影响.
- 经常接触坏消息 (BBN) 可以导致道德困境,同情疲劳和倦怠.
研究的目的:
- 审查坏消息 (BBN) 如何影响医生的专业身份形成 (PIF).
- 探索与BBN相关的关怀的个人成本.
- 确定在BBN期间支持医生的策略.
主要方法:
- 2000年至2024年间发表的关于BBN的研究的系统范围审查.
- 在PubMed,Embase,Scopus,CINAHL和PsycINFO进行的搜索.
- 使用了以主题和人格环理论 (RToP) 为指导的内容分析,并补充了人工智能用于三角化.
主要成果:
- 分析了31项研究,显示BBN要求医生平衡家庭目标与患者利益.
- BBN使医生倾向于照顾的个人成本,影响PIF.
- 不有效的组织支持加剧了这些负面影响.
结论:
- 打破坏消息显著影响医生PIF,并承担个人护理费用.
- 建议采用基于团队的BBN方法.
- 在整体计划中整合培训和纵向评估对于医生支持至关重要.
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