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儿科重症监护病房(PICU)复苏过程中父母在场情况:父母的经历。分享与度过复苏过程:一项现象学研究。

Parental presence during resuscitation in the PICU: the parents' experience. Sharing and surviving the resuscitation: a phenomenological study.

作者信息

Maxton Fiona J C

机构信息

School of Nursing, Midwifery & Social Care, Faculty of Health, Life and Social Sciences, Napier University, Edinburgh, UK.

出版信息

J Clin Nurs. 2008 Dec;17(23):3168-76. doi: 10.1111/j.1365-2702.2008.02525.x.

Abstract

AIM AND OBJECTIVE

To provide in-depth understanding of the meaning for parents who were present or absent during a resuscitation attempt on their child in the PICU.

BACKGROUND

Family presence during resuscitation remains a topic of debate with both benefits and disadvantages identified, yet few studies have asked parents of children in PICU to describe their experiences of being present or absent during this resuscitation and what this means to their understanding and coping. Additionally, minimal research has investigated parental presence during a successful resuscitation.

DESIGN

A qualitative design was used based upon van Manen's interpretative phenomenological approach.

METHODS

Fourteen parents of critically ill children from one paediatric intensive care unit in Australia, who had either survived or died following a resuscitation attempt were interviewed.

RESULTS

Four main themes were identified: (1) being only for a child; (2) making sense of a living nightmare; (3) maintaining hope in the face of reality; (4) living in a relationship with staff.

CONCLUSIONS

The findings underpin the inherent need for parents to choose to be present during resuscitation to make sense of the situation. Memories of the resuscitation were not long-lasting and distress was for the potential death of a child, rather than the resuscitation scene. Parents who did not witness their child's resuscitation were more distressed than those who did. Having the opportunity to make the decision to stay or leave was important for parents. Support during the resuscitation was best provided by experienced clinical nurses.

RELEVANCE TO PRACTICE

Recognition of the parents' compelling need to stay will improve nurses' understanding of how witnessing this event may assist family coping and functioning. Ways in which parents may be better supported in making the decision to stay or leave during resuscitation are identified.

摘要

目的

深入了解在儿科重症监护病房(PICU)对其孩子进行复苏尝试时在场或不在场的父母的感受。

背景

复苏期间家属在场仍是一个存在争议的话题,既有好处也有弊端,但很少有研究询问PICU中孩子的父母描述他们在复苏过程中在场或不在场的经历以及这对他们的理解和应对意味着什么。此外,极少有研究调查成功复苏过程中家属在场的情况。

设计

采用基于范曼解释现象学方法的质性设计。

方法

对澳大利亚一家儿科重症监护病房的14名重症患儿的父母进行了访谈,这些患儿在复苏尝试后存活或死亡。

结果

确定了四个主要主题:(1)只为孩子;(2)理解噩梦般的经历;(3)面对现实保持希望;(4)与医护人员建立关系。

结论

研究结果强调了父母在复苏期间选择在场以理解情况的内在需求。复苏的记忆并不持久,痛苦来自孩子可能的死亡,而非复苏场景。未目睹孩子复苏的父母比目睹的父母更痛苦。有机会决定留下或离开对父母很重要。复苏期间最好由经验丰富的临床护士提供支持。

与实践的相关性

认识到父母留下的迫切需求将提高护士对目睹这一事件如何帮助家庭应对和功能恢复的理解。确定了在复苏期间如何更好地支持父母做出留下或离开决定的方法。

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