Donnelly Frank, Wiechula Rick
Department of Clinical Nursing, University of Adelaide, Adelaide, Australia.
J Clin Nurs. 2006 Sep;15(9):1115-22. doi: 10.1111/j.1365-2702.2006.01384.x.
To investigate the lived experience patients have of a tracheostomy tube change.
Few interpretive studies have looked at specific nursing interventions in relation to nursing practice. This study has investigated the lived experience of patients from an intensive care unit that have had a tracheostomy tube change. The tracheostomy is a significant intervention for many patients within critical care.
Using a phenomenological approach, guided by the insights of Martin Heidegger and Max van Manen, participants were interviewed with their responses being transcribed into a text. This text has been subject to hermeneutic analysis using the theories of Paul Ricoeur. This hermeneutic approach has required using the text (discourse) as the focus of the interpretation.
The findings of this study imply that the experience of a tracheostomy tube change is more complex than that of simply a physical sensation. There is a need for participants to prepare themselves psychologically, a process that requires not only the trust of nursing staff but also the assessment by the participant that the nursing staff member has a level of competence to perform the task. The need for maintaining communication and the ability to speak were at times more significant for participants than even the risk of other airway complications.
This study has highlighted the potential for further interpretive studies into some of the more specific aspects of caring for patients that have been or are critically ill. The themes revealed will enable the nurse, required to change a tracheostomy tube, to do so with an improved level of empathy and understanding.
调查患者气管切开套管更换的实际体验。
很少有解释性研究关注与护理实践相关的具体护理干预措施。本研究调查了重症监护病房中接受气管切开套管更换的患者的实际体验。气管切开术对许多重症患者来说是一项重要的干预措施。
采用现象学方法,在马丁·海德格尔和马克斯·范·曼嫩的见解指导下,对参与者进行访谈,并将他们的回答转录成文本。该文本已使用保罗·利科的理论进行诠释学分析。这种诠释学方法要求以文本(话语)作为诠释的重点。
本研究结果表明,气管切开套管更换的体验比单纯的身体感觉更为复杂。参与者需要在心理上做好准备,这一过程不仅需要信任护理人员,还需要参与者评估护理人员具备执行该任务的能力水平。对参与者来说,保持沟通和说话能力有时甚至比其他气道并发症的风险更为重要。
本研究强调了对重症或曾患重症患者护理的一些更具体方面进行进一步解释性研究的潜力。所揭示的主题将使负责更换气管切开套管的护士能够以更高的同理心和理解水平进行操作。