Sigurgeirsdottir Jonina, Halldorsdottir Sigridur
Reykjalundur Rehabilitation Centre, Mosfellsbaer, Iceland.
J Adv Nurs. 2008 Feb;61(4):384-92. doi: 10.1111/j.1365-2648.2007.04531.x.
This paper is a report of a study to increase understanding of patients' experience of rehabilitation and their self-reported needs in that context.
Nurses need to be able to recognize patient needs to plan effective and individualized care. Needs-led nursing care is emphasized in the nursing literature, but few studies in rehabilitation have explored needs from the patient's perspective.
The sample of this phenomenological study was purposively selected and the data consisted of 16 in-depth interviews with 12 people aged between 26 and 85 years. The data were collected in 2005.
The findings showed that being a patient in rehabilitation involves existential struggling, as the reason behind patients' rehabilitation, accident or illness usually leads to trying to cope with existential changes while needing to adapt to new characteristics of life and self. This makes patients vulnerable and their self-reported needs include individualized caring and emotional support from family, peers and staff. Participants also reported a need for a sense of security in a stable and homelike environment, with assistance, help and presence. Finally, they reported needing goal-oriented and progressive care in which realistic and achievable goals were established. Individualized patient education enhanced their independence and empowered them towards a new and progressive lifestyle.
A new emphasis is needed in rehabilitation nursing, involving assessment of existential well-being of patients by means of skilful interpersonal relationship based on individualized caring and emotional support and recognition of each patient's own hierarchy of needs.
本文是一项研究报告,旨在增进对患者康复经历及其在此背景下自我报告需求的理解。
护士需要能够识别患者需求,以便规划有效的个性化护理。护理文献强调以需求为导向的护理,但康复领域很少有研究从患者角度探讨需求。
本现象学研究的样本是有目的地选取的,数据包括对12名年龄在26至85岁之间的人进行的16次深度访谈。数据于2005年收集。
结果表明,作为康复患者意味着存在生存挣扎,因为患者康复背后的原因,即事故或疾病,通常导致他们在需要适应生活和自我的新特征时,努力应对生存变化。这使患者变得脆弱,他们自我报告的需求包括来自家人、同伴和工作人员的个性化关怀和情感支持。参与者还报告说,在稳定且像家一样的环境中,需要安全感,同时需要他人的协助、帮助和陪伴。最后,他们报告需要目标导向且循序渐进的护理,其中要设定现实且可实现的目标。个性化的患者教育增强了他们的独立性,并使他们能够迈向新的、积极向上的生活方式。
康复护理需要有新的侧重点,包括通过基于个性化关怀和情感支持的熟练人际关系来评估患者的生存幸福感,并认识到每个患者自身的需求层次。