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新生儿重症监护病房护士和医生的临终体验

End-of-life experiences of nurses and physicians in the newborn intensive care unit.

作者信息

Epstein E G

机构信息

School of Nursing, University of Virginia, Charlottesville, VA 22908, USA.

出版信息

J Perinatol. 2008 Nov;28(11):771-8. doi: 10.1038/jp.2008.96. Epub 2008 Jul 3.

Abstract

OBJECTIVE

To explore nurses' and physicians' end-of-life (EOL) experiences in the newborn intensive care unit.

STUDY DESIGN

A hermeneutic phenomenology of health-care providers' lived experiences with infant deaths in the newborn intensive care unit between January and August 2006 was conducted. Semistructured interviews were completed with individual providers. Demographic data were also collected. Analysis of themes and descriptive statistics were performed.

RESULT

Twenty-one nurses and 11 physicians were interviewed. Providers described their experiences largely through an overall theme of 'creating the best possible experience' for parents. To support this theme, three subthemes (building relationships, preparing for the EOL and creating memories) were common between physicians and nurses. However, nurses and physicians articulated their roles and obligations differently within these subthemes. Additionally, three subthemes through which the providers described their personal experiences were found and these included moral distress, parental readiness and consent for autopsy.

CONCLUSION

A primary finding of this study was that a common overall obligation among nurses and physicians was to create the best possible experience for parents. Despite this commonality, the two disciplines approached the EOL and accomplished their common obligation from different vantage points.

摘要

目的

探讨新生儿重症监护病房护士和医生的临终关怀经历。

研究设计

对2006年1月至8月期间新生儿重症监护病房医护人员关于婴儿死亡的生活经历进行诠释现象学研究。对个体医护人员进行了半结构化访谈。还收集了人口统计学数据。进行了主题分析和描述性统计。

结果

对21名护士和11名医生进行了访谈。医护人员主要通过为父母“创造尽可能好的体验”这一总体主题来描述他们的经历。为支持这一主题,医生和护士之间有三个共同的子主题(建立关系、为临终做准备和创造回忆)。然而,护士和医生在这些子主题中对各自角色和义务的阐述有所不同。此外,还发现了医护人员描述其个人经历的三个子主题,包括道德困扰、父母对尸检的准备情况和同意。

结论

本研究的一个主要发现是,护士和医生的一个共同总体义务是为父母创造尽可能好的体验。尽管有这一共性,但两个学科从不同的角度处理临终关怀问题并履行其共同义务。

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本文引用的文献

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Harm and uncertainty in newborn intensive care.
Theor Med Bioeth. 2007;28(5):393-412. doi: 10.1007/s11017-007-9051-z.
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Infant end-of-life care: the parents' perspective.婴儿临终关怀:父母的观点。
J Perinatol. 2007 Aug;27(8):510-6. doi: 10.1038/sj.jp.7211755. Epub 2007 Apr 19.
7
Measuring end-of-life care outcomes prospectively.前瞻性地衡量临终关怀结果。
J Palliat Med. 2005;8 Suppl 1:S30-41. doi: 10.1089/jpm.2005.8.s-30.
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