White Patricia, Ferszt Ginette
Simmons College, School of Health Sciences, Nursing Programs, Boston, MA 02115, USA.
J Am Acad Nurse Pract. 2009 Apr;21(4):231-40. doi: 10.1111/j.1745-7599.2009.00398.x.
Nurse practitioners (NPs) have provided care to clients in primary care settings for more than 40 years. Although NP practice standards have identified grief as a health concern that needs to be addressed, little is known about the practice of NPs with this population. The purpose of this study was to describe the clinical practice of NPs in primary care with clients who were grieving the death of a significant person.
This descriptive exploratory qualitative study explored NPs' assessment, plan of care, and evaluation of healthcare outcomes for their clients who were grieving. Semi-structured audiotaped interviews with nine NPs providing primary care to clients were completed. The data were analyzed using qualitative content analysis.
The NPs' descriptions of their clinical practice yielded important information about their assessment, intervention, and evaluation of grieving clients. Descriptions of assessments by NPs provided important data that were categorized as physical complaints, overall functioning, and emotional well-being or coping. Descriptions of interventions included validation of clients' grief, prescriptions, and teaching or referral. Descriptions of outcomes included relief of physical complaints and stabilized chronic illness, improvements in overall functioning, and improvements in clients' emotional well-being and coping.
For NPs to be able to provide effective care to clients grieving the death of a loved one, they need a better understanding of theoretical models and current research related to grief. Further studies are needed to provide insight into the practice of NPs with this population.
执业护士（NPs）在初级保健机构为患者提供护理服务已有40多年。尽管执业护士的执业标准已将悲伤视为一个需要解决的健康问题，但对于执业护士在这一人群中的实践了解甚少。本研究的目的是描述初级保健中执业护士对正在哀悼重要人物死亡的患者的临床实践。
这项描述性探索性定性研究探讨了执业护士对正在悲伤的患者的评估、护理计划及医疗保健结果评估。完成了对9名在初级保健机构为患者提供服务的执业护士的半结构化录音访谈。采用定性内容分析法对数据进行分析。
执业护士对其临床实践的描述产生了有关他们对悲伤患者的评估、干预和评价的重要信息。执业护士对评估的描述提供了重要数据，这些数据可分为身体不适、整体功能以及情绪健康或应对能力。干预措施的描述包括对患者悲伤情绪的确认、开处方以及教学或转诊。结果的描述包括身体不适的缓解和慢性病的稳定、整体功能的改善以及患者情绪健康和应对能力的改善。
为了能够为正在哀悼亲人死亡的患者提供有效的护理，执业护士需要更好地理解与悲伤相关的理论模型和当前研究。需要进一步研究以深入了解执业护士在这一人群中的实践。
