Wiman Elisabeth, Wikblad Karin, Idvall Ewa
Faculty of Health Sciences, Department of Social and Welfare Studies, Norrköping, Linköping University, Sweden.
Int J Nurs Stud. 2007 Jul;44(5):714-22. doi: 10.1016/j.ijnurstu.2006.01.014. Epub 2006 Mar 23.
Encounters in emergency departments have been described from different perspective and with different research approaches. On reviewing the literature, along with medical skills, interpersonal skills such as the ability to create a relationship with the patient was considered significant. Patients exposed to high-energy violence arrive at the emergency department in a vulnerable condition. Apart from their physical condition, they might be in shock and frightened by the experiences of the injury. The team at the emergency department is responsible for a complex situation and has to quickly establish rapport, gather information, assess the physical condition, and design a treatment plan.
The aim of this study was to explore trauma patients' conceptions of the encounter with the trauma team.
A qualitative inductive design was used and data were collected by semi-structured interviews. The interviews were transcribed verbatim and analysed according to contextual analysis.
Twenty-three trauma patients with minor injuries, 17 from a university hospital and six from a county hospital with minor injuries, were included in the study.
The main findings were three main categories, labelled modes of being with the patients: the instrumental, the attentive and the uncommitted mode. All encounters contained the instrumental mode and mostly there were a combination of instrumental mode and attentive mode. The patients were satisfied with these modes, which created emotions of confidence, comfort and satisfaction. The uncommitted mode occurred in some encounters together and generated emotions of abandonment, dissatisfaction.
The main conclusion is that a high-quality encounter in trauma care is likely to be received from caregivers who can shift their mode of being with the patient between the instrumental and the attentive mode as the patient/situation demands. That is, flexibility between the physical and psycho-social care.
急诊室的接诊情况已从不同角度并采用不同研究方法进行了描述。在回顾文献时,人们发现除了医疗技能外,诸如与患者建立关系的能力等人际技能也很重要。遭受高能暴力的患者到达急诊室时处于脆弱状态。除了身体状况外,他们可能还处于休克状态,并因受伤经历而感到恐惧。急诊室团队负责处理复杂情况,必须迅速建立融洽关系、收集信息、评估身体状况并制定治疗方案。
本研究的目的是探讨创伤患者对与创伤团队接触的看法。
采用定性归纳设计,通过半结构化访谈收集数据。访谈逐字记录,并根据情境分析进行分析。
23名轻伤创伤患者参与了研究,其中17名来自大学医院,6名来自县医院。
主要结果分为与患者相处的三种主要模式:工具性模式、专注性模式和无承诺模式。所有接触都包含工具性模式,大多数情况下是工具性模式和专注性模式的结合。患者对这些模式感到满意,这些模式产生了自信、舒适和满意的情绪。无承诺模式在一些接触中同时出现,并产生了被遗弃、不满的情绪。
主要结论是,在创伤护理中,高质量的接触可能来自能够根据患者/情况的需求在工具性模式和专注性模式之间转换与患者相处方式的护理人员。也就是说,在身体护理和心理社会护理之间保持灵活性。