本科安宁疗护课程教学改革和成效分析

doi:10.3761/j.issn.1672-9234.2024.12.008

摘要/Abstract

摘要：

目的探讨安心卡在护理本科生安宁疗护课程教学中的应用效果。方法 2023年9月—10月，将安心卡运用于46名参加安宁疗护选修课程的大学三年级护理本科生的“死亡教育和终末期患者需求沟通”实验教学中。教学结束后，通过安心茶话屋参与者评价表、对目的抽取的8名学生进行半结构化访谈，深入了解学生的参与体验和感受。结果 46名学生共选择了138张安心卡，其中39张（28.3%）聚焦身体需求、39张（28.3%）聚焦心理需求、17张（12.3%）聚焦人际需求、43张（31.2%）聚焦精神需求。44名（95.7%）学生认为基于安心卡的学习是一次非常有意义的经历；40名（87.0%）学生认为基于安心卡讨论死亡更容易；40名（87.0%）学生表示会和亲人及医生讨论预立医疗照护计划；42名（91.3%）学生表示会完成自己的预立医疗照护计划；38名（82.6%）学生表示会鼓励家人和朋友完成他们的预立医疗照护计划；41名（89.1%）学生表示会向其他人推荐安心卡。通过分析访谈资料提炼出安心茶话屋活动趣味性与挑战性兼备，安心卡助力打破“讳死”语境、加深对安宁疗护的理解，期待安心卡与情境深入融合3个主题、7个子主题。结论在安宁疗护课程中应用安心卡，可以促进学生对死亡及临终话题的讨论，加深其对安宁疗护内涵的理解，并助力其克服“讳死”心理、寻找生命意义。

关键词: 教育, 护理, 安宁疗护, 本科生, 安心卡

Abstract:

Objective To explore the effect of using Heart to Heart cards in the Palliative Care course for undergraduate nursing students. Methods From September 2023 to October 2023，the Heart to Heart card was utilized in experimental teaching activities of death education and communication with end-stage patient needs for 46 third-year nursing undergraduate students taking an elective Palliative Care course. After the teaching，participants’ evaluation were collected through Heart to Heart Café and semi-structured interviews were conducted with 8 conveniently selected students to understand their experiences and feelings. Results A total of 138 Heart to Heart cards were selected by the 46 participants，of which 39（28.3%） focused on physical needs，39（28.3%） on psychological needs，17（12.3%） on interpersonal needs，and 43（31.2%） on spiritual needs. Most of the participants（95.7%） thought that the experience of playing the Heart to Heart cards was very meaningful；40（87.0%） participants thought that it was easier to discuss death using the Heart to Heart cards；40（87.0%） participants would discuss advance care plans with their relatives and doctors；42（91.3%） participants would complete their own advance care plans；38（82.6%） participants would encourage family and friends to complete their advance care plans；and 41（89.1%） participants would recommend the Heart to Heart cards to others. Through the analysis of interview data，three main themes and seven sub-themes were extracted，namely：1） the Heart to Heart Café talk activities were both interesting and challenging；2） the Heart to Heart cards aided in breaking the taboo around discussing death and enhancing understanding of palliative care；3） looking forward to a deeper integration of the Heart to Heart cards into various situations. Conclusion The use of Heart to Heart cards in palliative care courses can promote nursing students’ discussions on death and dying topics，deepen their understanding of the connotation of palliative care，and help them overcome the taboo surrounding death while finding meaning in life.

Key words: Education, Nursing, Hospice care, Baccalaureate, Heart to Heart cards

刘金龙, 楼妍, 徐云佳, 俞伊莉, 程琳, 李媛媛. 本科安宁疗护课程教学改革和成效分析[J]. 中华护理教育, 2024, 21(12): 1455-1461.

LIU Jinlong, LOU Yan, XU Yunjia, YU Yili, CHENG Lin, LI Yuanyuan. Reform and effectiveness analysis of experimental teaching in undergraduate Palliative Care course[J]. Chinese Journal of Nursing Education, 2024, 21(12): 1455-1461.

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