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肝移植患者:他们在重症监护病房的经历。一项现象学研究。

Liver transplant patients: their experience in the intensive care unit. A phenomenological study.

作者信息

del Barrio Miriam, Lacunza Ma Mar, Armendariz Ana Carmen, Margall Ma Angeles, Asiain Ma Carmen

机构信息

Critical Care Unit, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.

出版信息

J Clin Nurs. 2004 Nov;13(8):967-76. doi: 10.1111/j.1365-2702.2004.01002.x.

Abstract

BACKGROUND

The nurses' knowledge of patients' experiences contributes to gaining a deeper understanding of their health process, which will help to provide a better foundation for nursing care. The patients' experiences in the intensive care unit are singular; liver transplant patients constitute a specific group, because generally their admission to the intensive care unit marks the first step towards recovery of their health after a process in which they have lived in fear because their illness was reaching a more or less terminal stage.

AIM

To describe the liver transplant patient's experience in the intensive care unit.

DESIGN

Phenomenological descriptive qualitative study.

METHOD

In-depth interviews were carried out with a sample of 10 patients. The interviews were audiotaped and transcribed verbatim. The transcripts were analyzed using the method devised by Giorgi and modified by Baker.

RESULTS

After the data were analyzed, a general description emerged, which includes five themes reflecting the essence of what this group of patients experienced: preconceived ideas marked the way they approached transplant; captured impressions of the intensive care unit's environment and experienced sensations; their perception of the caring behaviour of the nursing staff; support from the social environment (family) and religious beliefs; and their preconceived idea of the intensive care unit contrasted with their lived experience.

CONCLUSION

This research enabled us to gain in-depth knowledge of the liver transplant patient's lived experience of the intensive care unit. Nurses can optimize the nursing care plan for this group of patients based on these results.

RELEVANCE TO CLINICAL PRACTICE

Awareness of the importance that these participants gave to discomfort caused in their basic needs should lead nurses to pay special attention to the nursing interventions to help with these needs. As a result of this research, nurses and other professionals in the intensive care unit know that patients have an immediate sense of positive change. This enables us to reinforce this perception, reminding them frequently that they have already had their transplant and they are progressing well, thereby aiding their recovery. With regard to the social support of liver transplant patients, nurses must facilitate the presence of family members at the patient's bedside, as participants stated that the only support they needed was that of their family.

摘要

背景

护士对患者经历的了解有助于更深入地理解患者的健康过程,这将有助于为护理工作提供更好的基础。重症监护病房患者的经历独特;肝移植患者构成一个特殊群体,因为一般来说,他们入住重症监护病房标志着在经历了因病情发展到或多或少的终末期而充满恐惧的阶段后,迈向健康康复的第一步。

目的

描述肝移植患者在重症监护病房的经历。

设计

现象学描述性定性研究。

方法

对10名患者进行了深入访谈。访谈进行了录音并逐字转录。使用 Giorgi 设计并经 Baker 修改的方法对转录文本进行分析。

结果

数据分析后得出了一个总体描述,其中包括五个主题,反映了这组患者经历的本质:先入之见影响了他们对待移植的方式;对重症监护病房环境的印象和感受;他们对护理人员关怀行为的认知;社会环境(家庭)和宗教信仰的支持;以及他们对重症监护病房的先入之见与实际经历形成的反差。

结论

本研究使我们能够深入了解肝移植患者在重症监护病房的实际经历。护士可基于这些结果优化针对这组患者的护理计划。

与临床实践的相关性

认识到这些参与者对其基本需求所产生不适的重视程度,应促使护士特别关注满足这些需求的护理干预措施。这项研究的结果表明,重症监护病房的护士和其他专业人员了解到患者能立即感受到积极的变化。这使我们能够强化这种认知,经常提醒他们已经接受了移植手术且进展良好,从而有助于他们康复。关于肝移植患者的社会支持,护士必须为家庭成员陪伴患者床边提供便利,因为参与者表示他们唯一需要的支持就是家人的支持。

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