Challenges Faced by Nurses Working in Palliative Care Centers

Öz

Objective: This study was conducted to determine the difficulties experienced by nurses working in palliative care centers. Methods: Data were collected using the descriptive "Personal and Professional Introductory Information Form" prepared by the researcher and the "Palliative Care Difficulties Scale (PCDS)". In the evaluation of the data; numbers, percentages and means, Independent t-test, One Way ANOVA test, Mann Whitney U test, Kruskal-Wallis test, Spearman Correlation test, and simple linear regression analysis test were used. The significance level of statistical tests was accepted as p<0.05. Results: It was determined that 92.5% of the nurses participating in the study were women, 49.1% were between the ages of 31-40, 75.5% had a bachelor's degree, and 82.1% worked with palliative care patients for 0-5 years. The total mean score of nurses' PCDS was 42.82±7.69, sub-dimensions of the scale communication in multidisciplinary teams 8.60±2.38, communication with patient and family 9.44±2.29, expert support 7.44±2.35, the mean score of 44±2.35, reducing symptoms 8.83±2.55, and communication coordination sub-dimension was 8.50±2.59, which was above the medium level. It was determined that the nurses participating in the study considered the inconvenience of work environment conditions, excessive workload, mobbing, the inadequacy of corporate culture, inability to make one-to-one decisions, and physical, economic and socio-cultural factors as palliative care barriers. Nurses stated that they needed team communication and expert support in wound care, tracheostomy care, positioning, and respiratory support practices, and they had difficulties. It was determined that there was a significant difference between the PCDS total score and its sub-dimensions (p<0.05). Conclusion: Nurses working in palliative care face many difficulties and it is thought that it is important to strengthen health services, and policies to remove these obstacles.

Anahtar Kelimeler

• palliative care
• nursing
• nursing care
• hospice and palliative care nursing

Palyatif Bakım Merkezlerinde Çalışan Hemşirelerin Karşılaştığı Zorluklar

Öz

Amaç: Bu çalışma, palyatif bakım merkezlerinde çalışan hemşirelerin yaşadıkları zorlukları belirlemek amacıyla yapılmıştır. Yöntem: Veriler, araştırmacı tarafından hazırlanan tanımlayıcı veri toplama formu ve Palyatif Bakım Zorlukları Ölçeği (PBZÖ) kullanılarak toplanmıştır. Verilerin değerlendirilmesinde; sayı, yüzde ve ortalamalar, Independent t testi, One Way ANOVA testi, Mann Whitney U testi, Kruskal-Wallis testi, Spearman Korelasyon testi, basit doğrusal regresyon analiz testi kullanılmıştır. İstatistiksel testlerin anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Bulgular: Çalışmaya katılan hemşirelerin %92,5’i kadın, %49,1’i 31-40 yaş arasında, %75,5’i lisans mezunu, %82,1’inin palyatif bakım hastalarıyla çalışma süresi 0-5 yıl olduğu belirlenmiştir. Hemşirelerin PBZÖ toplam puan ortalaması 42,82±7,69, ölçek alt boyutlarından “multidisipliner ekiplerde iletişim” 8,60±2.,38, “hasta ve aile ile iletişim” 9,44±2,29, “uzman desteği” 7,44±2,35, “belirtilerin azaltılması” 8,83±2,55 ve “iletişim koordinasyonu” alt boyutu puan ortalamaları 8,50±2,59 olarak orta düzeyin üzerinde bulunmuştur. Çalışmaya katılan hemşireler iş ortamı koşullarının uygunsuzluğunu, iş yükü fazlalığını, mobbingi, kurum kültürü yetersizliğini, birebir karar verememeyi, fiziksel, ekonomik ve sosyo kültürel etkenleri palyatif bakım engeli olarak gördükleri belirlenmiştir. PBZÖ toplam puanı ve alt boyutları arasında istatistiksel olarak anlamlı bir farklılığın olduğu saptanmıştır (p<0,05). Hemşireler, yara bakımı, trakeostomi bakımı, pozisyon verme ve solunum desteği uygulamalarında ekip iletişimi ve uzman desteğine ihtiyaç duyduklarını ve zorlandıklarını belirtmişlerdir. Sonuç: Palyatif bakımda çalışan hemşireler birçok zorlukla karşılaşmakta ve yaşadıkları bu engellerin kaldırılmasına yönelik sağlık hizmetleri ve politikaların güçlendirilmesinin önemli olduğu düşünülmektedir.

Anahtar Kelimeler

• palyatif bakım
• hemşirelik
• hemşirelik bakımı

Kaynakça

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