Nordgren Lena, Olsson Henny
Department of Caring and Public Health Sciences, Mälardalen University, Västerås, Sweden.
J Clin Nurs. 2004 Feb;13(2):185-93. doi: 10.1111/j.1365-2702.2004.00816.x.
Earlier research has shown that physicians and nurses are motivated to provide good palliative care, but several factors prevail that prevent the best care for dying patients. To provide good palliative care it is vital that the relationship between nurses and physicians is one based on trust, respect and sound communication. However, in settings such as a coronary care unit, disagreement sometimes occurs between different professional groups regarding care of dying patients.
The aim of this study was to describe and understand physicians' and nurses' perceptions on their working relationship with one another and on palliative care in a coronary care unit setting.
Using a convenience sample, professional caregivers were interviewed at their work in a coronary care unit in Sweden.
Data collection and analysis were done concurrently using a qualitative approach.
From the interviews, a specific pattern of concepts was identified. The concepts were associated with a dignified death, prerequisites for providing good palliative care and obstacles that prevented such care.
Caregivers who work in a coronary care unit are highly motivated to provide the best possible care and to ensure a dignified death for their patients. Nevertheless, they sometimes fail in their intentions because of several obstacles that prevent good quality care from being fully realized.
To improve practice, more attention should be paid to increasing dying patients' well-being and participation in care, improving strategic decision-making processes, offering support to patients and their relatives, and improving communication and interaction among caregivers working in a coronary care unit. Caregivers will be able to support patients and relatives better if there are good working relations in the work team and through better communication among the various professional caregivers.
早期研究表明，医生和护士有动力提供良好的姑息治疗，但存在一些因素阻碍了为濒死患者提供最佳护理。要提供良好的姑息治疗，护士与医生之间的关系基于信任、尊重和良好的沟通至关重要。然而，在冠心病监护病房等环境中，不同专业群体在濒死患者护理方面有时会出现分歧。
本研究的目的是描述和理解医生和护士对他们在冠心病监护病房环境中彼此工作关系以及对姑息治疗的看法。
采用便利抽样，对瑞典一家冠心病监护病房的专业护理人员进行了工作中的访谈。
使用定性方法同时进行数据收集和分析。
从访谈中确定了一种特定的概念模式。这些概念与尊严死、提供良好姑息治疗的先决条件以及阻碍此类护理的障碍相关。
在冠心病监护病房工作的护理人员有高度的动力为患者提供尽可能好的护理并确保患者尊严死。然而，由于一些阻碍高质量护理充分实现的障碍，他们有时未能达成目标。
为了改进实践，应更加关注提高濒死患者的幸福感和参与护理的程度，改善战略决策过程，为患者及其亲属提供支持，以及改善冠心病监护病房护理人员之间的沟通和互动。如果工作团队中有良好的工作关系并且各专业护理人员之间有更好的沟通，护理人员将能够更好地支持患者及其亲属。
