Pugh Dale
Air Med J. 2002 Mar-Apr;21(2):28-36. doi: 10.1067/mmj.2002.122906.
This article describes a phenomenologic study of Western Australian flight nurses' clinical decision-making in emergency situations in which they were the sole health professional.
Following a phenomenologic method, in-depth interviews were analyzed by the method Colaizzi described. The phenomenon of clinical decision-making in emergency situations was explicated and illustrated by a thematic analysis.
A gestalt of knowing was identified by the interrelationships of the themes Ways of Knowing the Patient, Context of Knowing, and Reflective Practice. The theme Ways of Knowing the Patient is formed by the subthemes of intuitive, experiential, and objective knowing. The subthemes of aviation environment, no or minimized involvement in triage, knowing colleagues, sole practitioner, experiential level, and practice guidelines form the theme Context of Knowing. The third theme, Reflective Practice, consists of the subthemes self-critique and change in practice.
The findings address the paucity of knowledge of the phenomenon of clinical decision-making in this context of flight nursing practice.
本文描述了一项针对西澳大利亚州飞行护士在仅其为唯一医疗专业人员的紧急情况下临床决策的现象学研究。
采用现象学方法,运用科莱齐所描述的方法对深度访谈进行分析。通过主题分析对紧急情况下临床决策现象进行了阐释和说明。
通过“了解患者的方式”“了解的背景”和“反思性实践”这几个主题的相互关系,确定了一种认知的整体模式。“了解患者的方式”主题由直觉性、经验性和客观性了解这几个子主题构成。“了解的背景”主题的子主题包括航空环境、未参与或尽量减少参与分诊、了解同事、独自执业者、经验水平和实践指南。第三个主题“反思性实践”由自我批判和实践改变这几个子主题组成。
研究结果弥补了飞行护理实践中这一临床决策现象相关知识的不足。