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一项关于精神科护士如何照料自杀倾向患者的修正型扎根理论研究。

A modified grounded theory study of how psychiatric nurses work with suicidal people.

作者信息

Cutcliffe John R, Stevenson Chris, Jackson Sue, Smith Paul

机构信息

University of Tennessee, Knoxville, USA.

出版信息

Int J Nurs Stud. 2006 Sep;43(7):791-802. doi: 10.1016/j.ijnurstu.2005.09.001. Epub 2005 Nov 10.

Abstract

BACKGROUND

People with mental health problems continue to present a disproportionately high risk of suicide. Despite the relevance of suicide to psychiatric/mental health (P/MH) nurses, there is a documented paucity of research in this substantive area undertaken by or referring specifically to P/MH nurses; there is currently no extant theory to guide P/MH nursing care of the suicidal person.

OBJECTIVES

Accordingly, this paper reports on a study undertaken to determine if P/MH nurses provide meaningful caring response to suicidal people, and if so how.

DESIGN

The study used a modified grounded theory method and was conducted in keeping with the Glaserian tenets of Grounded Theory.

SETTINGS

The study was conducted in two geographical locations within the United Kingdom, one in the North and the other in the Midlands; both locations contained large urban centres.

PARTICIPANTS

A total of 20 participants were selected across the locations by means of theoretical sampling. All the participants were over 18 years old, had made a serious attempt on their lives or felt they were on the cusp of so doing and had received 'crisis' care from the 'emergency' psychiatric services.

METHODS

The study adhered to the principle features of Glaserian grounded theory namely-(a) theory generation, not theory verification; (b) theoretical sampling, (c) the constant comparative method of data analysis; and (d) theoretical sensitivity (searching for/discovering the core variable, one which identified the key pychosocial process and contains temporal dimensions stages). Further, the authors ensured that the study was concerned with generating conceptual theory, not conceptual description.

FINDINGS/CONCLUSION: The findings indicate that this key psychosocial problem is addressed through the core variable, 're-connecting the person with humanity'. This parsimonious theory describes and explains a three-stage healing process consisting of the sub-core variables: 'reflecting an image of humanity', 'guiding the individual back to humanity' and 'learning to live'.

摘要

背景

有心理健康问题的人群自杀风险持续居高不下。尽管自杀与精神科/心理健康(P/MH)护士密切相关,但有记录表明,该领域由P/MH护士开展或专门提及P/MH护士的研究匮乏;目前尚无现成理论可指导对有自杀倾向者的P/MH护理。

目的

因此,本文报告一项研究,旨在确定P/MH护士是否对有自杀倾向者提供了有意义的关怀回应,若提供了,是如何做到的。

设计

本研究采用了改良的扎根理论方法,并依据扎根理论的格拉斯理论原则开展。

地点

研究在英国的两个地理位置进行,一个在北部,另一个在中部地区;两地均有大型城市中心。

参与者

通过理论抽样在各地共选取了20名参与者。所有参与者均年满18岁,曾有过严重自杀未遂行为或感觉自己即将实施自杀行为,并接受过“急诊”精神科服务的“危机”护理。

方法

本研究遵循格拉斯扎根理论的主要特征,即:(a)理论生成,而非理论验证;(b)理论抽样;(c)数据分析的持续比较法;(d)理论敏感性(寻找/发现核心变量,该变量确定关键的心理社会过程并包含时间维度阶段)。此外,作者确保本研究关注的是生成概念性理论,而非概念性描述。

研究结果/结论:研究结果表明,这一关键的心理社会问题通过核心变量“使人与人重新建立联系”得以解决。这一简洁的理论描述并解释了一个由子核心变量组成的三阶段治愈过程:“反映人性形象”、“引导个体回归人性”和“学会生活”。

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