Rehabilitation Nursing Research and Development Unit, Royal Rehabilitation Centre Sydney, Flinders University, Sydney, Australia.
Clin Rehabil. 2009 Dec;23(12):1124-35. doi: 10.1177/0269215509343233.
To develop a grounded theory of nursing's contribution to patient rehabilitation from the perspective of nurses working in inpatient rehabilitation.
Grounded theory method, informed by the theoretical perspective of symbolic interactionism, was used to guide data collection and analysis, and the development of a grounded theory.
Five inpatient rehabilitation units in Australia.
Thirty-five registered and 18 enrolled nurses participated in audio-taped interviews and/or were observed during periods of their everyday practice.
The analysis revealed a situation whereby nurses made decisions about when to 'opt in' and when to 'opt out' of inpatient rehabilitation. This occurred on two levels: with their interaction with patients and allied health professionals, and when faced with negative system issues that impacted on their ability to contribute to patient rehabilitation. The primary contribution nurses made to inpatient rehabilitation was working directly with patients, enabling them to self-care. Nurses coached patients when their decisions about 'opting in' and 'opting out' were based on assessment of the person in their particular context. In contrast, the nurses mostly distanced themselves from system-based problems, 'opting out' of addressing them. They did this not to make their working lives easier, but more manageable.
System-based problems impacted negatively on the nurses' ability to deliver comprehensive rehabilitation care. As a consequence, some nurses felt unable to influence the care and they withdrew professionally to make their work lives more manageable.
从在住院康复病房工作的护士的角度出发，构建一个关于护理对患者康复贡献的扎根理论。
扎根理论方法，受符号互动主义理论观点的启发，用于指导数据收集和分析，并发展一个扎根理论。
澳大利亚的五家住院康复病房。
35 名注册护士和 18 名注册护士参加了录音采访，并在他们日常工作期间进行了观察。
分析揭示了一种情况，即护士决定何时“参与”和何时“退出”住院康复。这发生在两个层面上：与患者和联合健康专业人员的互动，以及面对影响他们为患者康复做出贡献的能力的负面系统问题时。护士对住院康复的主要贡献是与患者直接合作，使他们能够自我护理。当患者关于“参与”和“退出”的决定是基于对其特定背景下的人的评估时，护士会指导他们。相比之下，护士大多与基于系统的问题保持距离，“退出”解决这些问题。他们这样做不是为了让自己的工作生活更轻松，而是为了更具可管理性。
基于系统的问题对护士提供全面康复护理的能力产生了负面影响。因此，一些护士觉得无法影响护理，他们专业地退出，以使自己的工作生活更具可管理性。
