Background

An innovative program, ‘Paramedics Providing Palliative Care at Home,’ was implemented in Nova Scotia, Canada in 2015. Roles like this are part of an evolving professional identity; role discordance or lack of clarity not only hinders professionalization but may impair the wellbeing, and career longevity of paramedics. This study explored the alignment of providing palliative support at home with paramedic professional identity.

Methods

Qualitative description was employed, with thematic analysis of focus groups with paramedics and palliative health care providers. Recruitment posters were sent through the professional college (paramedics) and program managers (health care providers). Focus groups followed a semi-structured guide, discussing understanding of and experiences with the role and its alignment with professional identity. Challenges to paramedic palliative support and fit with professional identify were explored. Thematic content analysis was ongoing while focus groups were being conducted, until no new codes were found. Codes were combined, sorted into categories, and ultimately, agreed-upon themes. Saturation of themes was reached.

Results

Eleven paramedics and twenty palliative health care providers participated. Four themes reflected paramedic’s expanded role: (1) patient centeredness and job satisfaction with provision of palliative support, (2) a bridging role, (3) paramedic as advocate and educator, (4) provision of psychosocial support. Four themes reflected paramedic’s professional identity: (1) evolution of paramedicine as a skilled clinical profession, (2) helping people and communities, (3) paramedic skill set aligns with work in palliative care, and (4) changing paramedic mindset.

Conclusion

Paramedics and palliative health care providers highlighted the provision of palliative care as part of a positive growth of paramedicine as a health profession, and a good fit with professional identity. Novel roles like this are important in the evolution of our health care system faced with increasing pressures to get the right care with the right provider at the right time.

中文翻译：

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在家提供姑息治疗符合护理人员的专业身份：对护理人员和姑息治疗提供者的定性研究

背景

2015 年在加拿大新斯科舍实施了一项名为“在家提供姑息治疗的护理人员”的创新计划。像这样的角色是不断发展的专业身份的一部分；角色不一致或不明确不仅会阻碍专业化，而且可能会损害护理人员的福祉和职业寿命。本研究探讨了在家中提供姑息性支持与护理人员专业身份的一致性。

方法

采用定性描述，对焦点小组与护理人员和姑息治疗提供者进行专题分析。招聘海报通过专业学院（护理人员）和项目经理（医疗保健提供者）发送。焦点小组遵循半结构化指南，讨论对角色的理解和体验及其与专业身份的一致性。探讨了护理人员姑息支持和与专业身份相符的挑战。在进行焦点小组讨论时，主题内容分析正在进行中，直到没有发现新的代码。代码被组合，分类，并最终商定主题。主题已经饱和。

结果

有 11 名护理人员和 20 名姑息治疗提供者参加。四个主题反映了护理人员的扩展作用：(1) 以患者为中心和对提供姑息性支持的工作满意度，(2) 桥梁作用，(3) 护理人员作为倡导者和教育者，(4) 提供社会心理支持。四个主题反映了护理人员的专业身份：(1) 护理人员作为一种熟练的临床专业的演变，(2) 帮助人们和社区，(3) 护理人员的技能组合与姑息治疗工作相一致，以及 (4) 改变护理人员的心态。

结论

护理人员和姑息治疗提供者强调提供姑息治疗是护理人员作为健康专业积极发展的一部分，并且非常适合专业身份。像这样的新角色对于我们的医疗保健系统的发展非常重要，因为我们面临着越来越大的压力，需要在正确的时间从正确的提供者那里获得正确的护理。