Silén Marit, Svantesson Mia, Ahlström Gerd
School of Health Sciences, Jönköping University, Jönköping, Sweden.
Nurs Ethics. 2008 Mar;15(2):160-73. doi: 10.1177/0969733007086014.
The aim of this study was to describe nurses' conceptions of decision making with regard to life-sustaining treatment for dialysis patients. Semistructured interviews were conducted with 13 nurses caring for such patients at three hospitals. The interview material was subjected to qualitative content analysis. The nurses saw decision making as being characterized by uncertainty and by lack of communication and collaboration among all concerned. They described different ways of handling decision making, as well as insufficiency of physician-nurse collaboration, lack of confidence in physicians, hindrances to patient participation, and ambivalence about the role of patients' next of kin. Future research should test models for facilitating communication and decision making so that decisions will emerge from collaboration of all concerned. Nurses' role in decision making also needs to be discussed.
本研究旨在描述护士对于透析患者维持生命治疗决策的看法。对三家医院中照顾此类患者的13名护士进行了半结构式访谈。对访谈材料进行了定性内容分析。护士们认为决策具有不确定性，且所有相关方之间缺乏沟通与协作。他们描述了处理决策的不同方式，以及医护协作不足、对医生缺乏信心、患者参与的障碍，以及对患者近亲角色的矛盾态度。未来的研究应测试促进沟通和决策的模式，以便决策能由所有相关方协作产生。护士在决策中的作用也需要进行讨论。
