Lindahl Elisabeth, Norberg Astrid, Söderberg Anna
Department of Nursing, Umeå University, Umeå, Sweden.
J Clin Nurs. 2007 Mar;16(3A):68-75. doi: 10.1111/j.1365-2702.2005.01550.x.
This study illuminates the meaning of living with malodorous, exuding ulcers.
Difficulties for patients with chronic ulcers and the ulcers' impact on patients' daily life are described in the literature. Suffering and consolation are also addressed in the literature as important issues in nursing care.
The first author interviewed seven women and two men, aged 41-95, with various diagnoses.
We interpreted the transcribed interviews using a phenomenological hermeneutic method.
Two processes were identified: 'being struck down'- themes: feeling dirty, being trapped, losing confidence, losing hope, becoming frustrated and protecting oneself; and 'finding consolation'- themes: experiencing kinship, encountering genuineness and gaining control. The meaning of living with malodorous and exuding ulcers can be understood as being trapped in a debilitating process that slowly strikes one down. There is a longing for purity and wholeness and for one's life to improve. When people with malodorous, exuding ulcers encounter genuineness and feel loved, regarded and respected as fully human despite their ulcers, they feel purified. The contaminated body no longer contaminates their self-image and self-esteem and they feel restored and fully human again. Only when they feel fully human can they regain control and see life beyond their ulcers.
Although nurses cannot make ulcers or smell disappear, they can contribute significantly to improve the patients' life. Finding consolation makes patients feel purified despite their contaminated body.
This study points to the importance of seeing the human being beyond the ulcer and considering not only the body but the whole person.
本研究阐明了患有散发恶臭、渗液性溃疡的生活意义。
文献中描述了慢性溃疡患者所面临的困难以及溃疡对患者日常生活的影响。文献中还提到了痛苦和慰藉是护理中的重要问题。
第一作者采访了7名女性和2名男性，年龄在41 - 95岁之间，患有各种疾病。
我们采用现象学诠释学方法对转录的访谈进行解读。
确定了两个过程：“被击倒”——主题包括：感觉肮脏、被困住、失去信心、失去希望、变得沮丧以及自我保护；“找到慰藉”——主题包括：体验亲情、遇到真诚以及获得掌控感。患有散发恶臭、渗液性溃疡的生活意义可理解为被困在一个使人衰弱的过程中，这个过程会慢慢将人击倒。人们渴望纯净和完整，渴望生活得到改善。当患有散发恶臭、渗液性溃疡的人遇到真诚，并感到尽管有溃疡但仍被当作完整的人来关爱、尊重时，他们会感到被净化。受污染的身体不再影响他们的自我形象和自尊，他们会感觉恢复如初，再次成为完整的人。只有当他们感觉自己是完整的人时，才能重新获得掌控感，看到溃疡之外的生活。
尽管护士无法让溃疡或异味消失，但他们能在很大程度上改善患者的生活。找到慰藉能让患者尽管身体受污染但仍感觉被净化。
本研究指出了超越溃疡看待患者、不仅考虑身体而且考虑整个人的重要性。
