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2009 年甲型 H1N1 流感大流行期间澳大利亚重症监护病房医护人员的经历:一项现象学研究。

The experiences of health care workers employed in an Australian intensive care unit during the H1N1 Influenza pandemic of 2009: a phenomenological study.

机构信息

Clinical Research Nurse, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.

出版信息

Int J Nurs Stud. 2010 May;47(5):577-85. doi: 10.1016/j.ijnurstu.2009.11.015. Epub 2009 Dec 28.

Abstract

BACKGROUND

The H1N1 Influenza A pandemic arrived in Australia in early May 2009. In Queensland, the highest number of H1N1 cases were admitted to the intensive care unit when compared with the other Australian states. While many recent studies examining the H1N1 pandemic have focussed on service delivery and disease epidemiology, few have explored the lived experiences of frontline health care workers caring for the patients in the intensive care unit.

OBJECTIVES

The purposes of this study were to: document and describe the lived experiences of the nursing and medical staff caring for patients in the intensive care unit during the H1N1 pandemic; to validate the staffs' experiences; and to assist in informing future pandemic planning by highlighting the collective experiences of these frontline health care workers.

DESIGN

A phenomenological study method was used.

SETTING AND PARTICIPANTS

34 staff from a tertiary referral hospital in Brisbane, Australia participated in the study.

METHODS

Data was collected using an open ended questionnaire and focus groups. The resulting responses were analysed using Colaizzi's framework to discover regular patterns of meaning that emerged.

RESULTS

Eight common themes emerged: the wearing of personal protective equipment; infection control procedures; the fear of contracting and transmitting the disease; adequate staffing levels within the intensive care unit; new roles for staff; morale levels; education regarding extracorporeal membrane oxygenation; and the challenges of patient care. These eight themes articulate the lived experience of the staff during the height of the H1N1 Influenza pandemic period.

CONCLUSIONS

Planning for a pandemic situation is invariably difficult due to the unpredictable nature of the event itself. Recommendations for future pandemic planning which can be drawn from this study include the appointment of a dedicated infection control representative to provide information and support regarding infection control matters; the maintenance of effective communication channels is crucial; and the increased staffing requirements across nursing, medical, allied health and ancillary staff to cope with the higher patient numbers and acuity must be anticipated and planned for.

摘要

背景

甲型 H1N1 流感于 2009 年 5 月初抵达澳大利亚。在昆士兰州,与其他澳大利亚州相比,重症监护病房收治的 H1N1 病例数最多。虽然许多最近研究甲型 H1N1 流感大流行都集中在服务提供和疾病流行病学方面,但很少有研究探索照顾重症监护病房患者的一线医护人员的生活经历。

目的

本研究的目的是:记录和描述在甲型 H1N1 流感大流行期间照顾重症监护病房患者的护理和医务人员的生活经历;验证工作人员的经验;并通过突出这些一线医护人员的集体经验,协助为未来的大流行规划提供信息。

设计

采用现象学研究方法。

地点和参与者

澳大利亚布里斯班的一家三级转诊医院的 34 名工作人员参与了这项研究。

方法

使用开放式问卷调查和焦点小组收集数据。使用 Colaizzi 的框架分析得出的结果,以发现出现的有规律的意义模式。

结果

出现了八个共同主题:个人防护设备的佩戴;感染控制程序;感染和传播疾病的恐惧;重症监护病房内的充足人员配备水平;员工的新角色;士气水平;体外膜氧合的教育;以及患者护理的挑战。这八个主题阐明了工作人员在甲型 H1N1 流感大流行高峰期的生活经历。

结论

由于事件本身的不可预测性,对大流行情况的规划总是具有挑战性。可以从这项研究中得出的未来大流行规划建议包括任命专门的感染控制代表,提供有关感染控制事项的信息和支持;保持有效的沟通渠道至关重要;并且必须预计并规划增加护理、医疗、联合健康和辅助人员的人员配备要求,以应对更高的患者数量和严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d770/7125717/7c5210c008bc/gr1.jpg

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