Tutton Elizabeth, Seers Kate, Langstaff Debbie
Kadoorie Centre, Oxford Radcliffe Hospitals NHS Trust, and RCN Research Institute, University of Warwick, UK.
J Adv Nurs. 2008 Jan;61(2):145-53. doi: 10.1111/j.1365-2648.2007.04471.x.
This paper is a report of a study to explore the day-to-day experiences of patients and staff on a unit dedicated to the care of adult patients who have sustained an injury.
With the numbers of people suffering traumatic injury increasing, provision of their acute care and rehabilitation is also of increasing concern. Staff have the potential to optimize recovery but the factors that facilitate or inhibit this in practice are unclear.
This ethnographic study took place on a trauma unit in the United Kingdom between November 2004 and January 2006. Sixteen periods of observation, qualitative interviews with 40 patients and 19 staff, and four focus groups with staff were undertaken. Thematic analysis was conducted and data were analysed by sentence.
The dynamic process of patient-centred care was expressed through the themes of closeness, therapeutic care and working as a team. Closeness conveyed the sudden and devastating nature of injury, and the necessity for staff to let go of feelings to maintain a positive momentum. Therapeutic care highlighted the social connection between the staff and the patients, combined with a proactive dynamic approach to care. Working as a team identified the importance of maintaining expertise and making the system work for patients to ensure the best possible care.
By identifying the context and processes that facilitate recovery, it becomes possible to provide a framework for individuals and units to develop and improve practice that enhances recovery. These findings may be useful for other similar areas of care.
本文报告一项研究，旨在探究专门护理成年受伤患者的科室中患者与工作人员的日常经历。
随着遭受创伤性损伤的人数不断增加，为他们提供急性护理和康复服务也日益受到关注。工作人员有潜力优化康复过程，但在实际中促进或阻碍康复的因素尚不清楚。
这项人种学研究于2004年11月至2006年1月在英国的一个创伤科室进行。进行了16次观察期、对40名患者和19名工作人员进行了定性访谈，并与工作人员开展了4次焦点小组讨论。进行了主题分析，并逐句分析数据。
以患者为中心的护理动态过程通过亲密、治疗性护理和团队协作等主题得以体现。亲密体现了损伤的突然性和毁灭性，以及工作人员放下情感以保持积极势头的必要性。治疗性护理突出了工作人员与患者之间的社会联系，以及积极主动的护理方式。团队协作确定了保持专业知识并使系统为患者服务以确保提供最佳护理的重要性。
通过确定促进康复的背景和过程，有可能为个人和科室提供一个框架，以发展和改进实践从而促进康复。这些发现可能对其他类似护理领域有用。
