临终沟通情境模拟教学的设计及在护理临床教学中的应用研究

doi:10.3761/j.issn.1672-9234.2025.11.008

摘要/Abstract

摘要：

目的了解护理实习生在临终沟通情境模拟教学中的收获及对教学的建议。方法采用便利取样法，2024年9月—12月选取在杭州市5所三级甲等医院实习的24名护理专业学生作为教学对象，以安心卡（选择预测模式）作为教学媒介，以安宁疗护患者生命末期需求确认为切入点，对其实施临终沟通情境模拟教学。教学结束后，采用安心卡参与者评价表对全部护理实习生进行调查，并从中目的抽取8名护理实习生作为访谈对象，对其进行一对一的半结构化访谈，以了解护理实习生在教学中的收获及对教学的建议。结果 24名护理实习生均认为基于安心卡的学习是一次非常有意义的经历；其中23名认为借助安心卡讨论死亡话题会相对更容易。从访谈资料中提炼出4个主题：教学激发学生学习主动性，教学驱动学生沟通能力的内化过程，教学助力学生认知深化，学生期待教学从案例类型、教学时长两方面得到优化。结论护理实习生在临终沟通情境模拟教学中具有学习主动性，该教学在一定程度上有助于学生沟通能力的培养，促进学生对临床人文关怀实践的反思，且学生对将安心卡作为教学媒介持认可态度。未来还需结合护理实习生的建议对该教学行进一步优化。

关键词: 安宁疗护, 临终沟通, 生命末期需求确认, 安心卡, 护理实习生, 建构主义理论

Abstract:

Objective To understand the gains of nursing interns in the situational simulation teaching of discussing the end-of-life needs of patients in hospice care，as well as their suggestions for the teaching. MethodsUsing the convenient sampling method，24 nursing students interning in 5 tertiary grade A hospitals in Hangzhou City from September to December 2024 were selected as the participants. They received situational simulation teaching on identification of end-of-life needs of hospice patients，using the Heart to Heart Cards as the teaching medium. After the teaching，all nursing interns were surveyed using the Heart to Heart Cards Participant Evaluation Form，and 8 nursing interns were purposefully selected as interviewees for one-on-one semi-structured interviews to understand the interns’ gains in the teaching and their suggestions for the teaching. Results All nursing interns considered the learning based on the Heart to Heart Cards a very meaningful experience；among them，23 thought that discussing death-related topics with the help of the Heart to Heart Cards was relatively easier. Four themes were extracted from the interview data：teaching stimulates students’ learning initiative，teaching drives the internalization of students’ communication skills，teaching facilitates the deepening of students’ cognition，and students expect the teaching to be optimized in two aspects：case types and teaching duration. Conclusion The situational simulation teaching of confirmation about end-of-life needs of hospice patients integrated with the Heart to Heart Cards can mobilize nursing interns’ initiative in learning relevant teaching content，and to a certain extent，help cultivate their end-of-life communication and humanistic care abilities. Nursing interns hold a positive attitude toward integrating the Heart to Heart Cards into this end-of-life communication situational simulation. In the future，the teaching needs to be further optimized in combination with the suggestions of nursing interns.

Key words: Hospice and Palliative Care, End-of-life Communication, Confirmation about End-of-life Needs, Heart to Heart Cards, Nursing Interns, Constructivist Theory

刘金龙, 侯彬彬, 徐云佳, 夏云, 楼妍. 临终沟通情境模拟教学的设计及在护理临床教学中的应用研究[J]. 中华护理教育, 2025, 22(11): 1328-1335.

LIU Jinlong, HOU Binbin, XU Yunjia, XIA Yun, LOU Yan. Design of simulated teaching for end-of-life communication and its application among nursing interns[J]. Chinese Journal of Nursing Education, 2025, 22(11): 1328-1335.

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