Bach Vicky, Ploeg Jenny, Black Margaret
Fraser Health Authority, Canada.
West J Nurs Res. 2009 Jun;31(4):496-512. doi: 10.1177/0193945908331178. Epub 2009 Feb 10.
This study used a grounded theory approach to formulate a conceptual framework of the nursing role in end-of-life decision making in a critical care setting. Fourteen nurses from an intensive care unit and cardio-respiratory care unit were interviewed. The core concept, Supporting the Journey, became evident in four major themes: Being There, A Voice to Speak Up, Enable Coming to Terms, and Helping to Let Go. Nurses described being present with patients and families to validate feelings and give emotional support. Nursing work, while bridging the journey between life and death, imparted strength and resilience and helped overcome barriers to ensure that patients received holistic care. The conceptual framework challenges nurses to be present with patients and families at the end of life, clarify and interpret information, and help families come to terms with end-of-life decisions and release their loved ones.
本研究采用扎根理论方法，构建了重症监护环境下临终决策中护理角色的概念框架。对来自重症监护病房和心肺监护病房的14名护士进行了访谈。核心概念“支持旅程”在四个主要主题中得以体现：陪伴左右、勇于发声、达成和解、助力放手。护士们描述了陪伴患者及其家人以确认感受并给予情感支持。护理工作在连接生死旅程的同时，赋予力量和复原力，并帮助克服障碍，以确保患者获得全面护理。该概念框架促使护士在患者生命末期陪伴患者及其家人，澄清和解读信息，并帮助家人接受临终决策，放手让亲人离去。
