İstanbul ili palyatif bakım merkezlerinde çalışan hemşirelerin yaşadıkları zorluklar
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2021
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Open Access Color
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Bu çalışma, palyatif bakım merkezlerinde çalışan hemşirelerin yaşadıkları zorlukları belirlemek amacıyla yapılmıştır. Araştırmanın evrenini Ağustos 2021-Ekim 2021 tarihleri arasında İstanbul ilindeki beş farklı hastanenin palyatif bakım birimlerinde çalışan 116 hemşire oluşturmuştur. Tanımlayıcı ve kesitsel tipte yapılan araştırmada örneklem seçimine gidilmeden evren üzerinde çalışılmak istenmiş ancak örneklemi, pandemi nedeniyle sadece hizmet vermeye devam eden palyatif bakım ünitelerinde çalışan ve çalışmaya katılmaya gönüllü 106 (%91,37) hemşireler oluşturmuştur. 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. 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 gördüklerini, PBZÖ toplam puanı ve alt boyutları arasında 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 olarak palyatif bakımda çalışan hemşireler bir çok zorlukla karşılaşmakta ve yaşadıkları bu engellerin kaldırılmasına yönelik sağlık hizmetleri ve politikaların güçlendirilmesinin önemli olduğu düşünülmektedir. Anahtar kelimeler: Palyatif, Palyatif Bakım, Palyatif Bakım Hemşiresi.
This study was conducted to determine the difficulties experienced by nurses working in palliative care centers. The population of the study consisted of 116 nurses working in the palliative care units of five different hospitals in Istanbul between August 2021 and October 2021. In the descriptive and cross-sectional study, it was desired to study the universe without selecting a sample, but the sample consisted of 106 (91,37%) nurses working in the palliative care units that continued to serve only because of the pandemic and volunteered to participate in the study. Data were collected using the descriptive data collection form prepared by the researcher and the Palliative Care Difficulties Scale (PBCI). 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, simple linear regression analysis test were used. 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' PBRS 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, 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 who participated in the study perceived the inconvenience of work environment conditions, excessive workload, mobbing, inadequacy of corporate culture, inability to make one-to-one decisions, physical, economic and socio-cultural factors as palliative care barriers, and that there was a significant difference between the PBSC total score and its sub-dimensions (p< 0.05). Nurses stated that they needed team communication and expert support in wound care, tracheostomy care, positioning and respiratory support practices and they had difficulties. As a result, 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. Key words: Palliative, Palliative Care, Palliative Care Nurse.
This study was conducted to determine the difficulties experienced by nurses working in palliative care centers. The population of the study consisted of 116 nurses working in the palliative care units of five different hospitals in Istanbul between August 2021 and October 2021. In the descriptive and cross-sectional study, it was desired to study the universe without selecting a sample, but the sample consisted of 106 (91,37%) nurses working in the palliative care units that continued to serve only because of the pandemic and volunteered to participate in the study. Data were collected using the descriptive data collection form prepared by the researcher and the Palliative Care Difficulties Scale (PBCI). 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, simple linear regression analysis test were used. 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' PBRS 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, 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 who participated in the study perceived the inconvenience of work environment conditions, excessive workload, mobbing, inadequacy of corporate culture, inability to make one-to-one decisions, physical, economic and socio-cultural factors as palliative care barriers, and that there was a significant difference between the PBSC total score and its sub-dimensions (p< 0.05). Nurses stated that they needed team communication and expert support in wound care, tracheostomy care, positioning and respiratory support practices and they had difficulties. As a result, 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. Key words: Palliative, Palliative Care, Palliative Care Nurse.
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Hemşirelik, Hemşireler, Hemşirelik, Nursing, Hemşirelik araştırmaları, Nurses, Nursing, Hospis ve palyatif bakım hemşireliği, Nursing research, Palyatif bakım, Hospice and palliative care nursing, Palliative care, İstanbul, Istanbul
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122