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亲属探访机械通气清醒患者的体验——阐释学研究

Relatives' experiences of visiting a conscious, mechanically ventilated patient--a hermeneutic study.

机构信息

Department of Intensive Care Unit, Skaraborgssjukhus Skövde, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden.

出版信息

Intensive Crit Care Nurs. 2010 Apr;26(2):91-100. doi: 10.1016/j.iccn.2009.12.001. Epub 2010 Jan 8.

Abstract

BACKGROUND

In recent years, light or no sedation has become a common approach to invasive mechanical ventilation in patients with respiratory distress. The experience of visiting a conscious patient receiving mechanical ventilation in the ICU has to our knowledge not yet been investigated.

AIM

The aim of the study was to describe the meaning attributed by relatives to their experiences of meeting, seeing and communicating with a patient cared for on a mechanical ventilator while conscious.

METHOD

This study used a prospective, exploratory design comprising interviews with ten relatives conducted on two occasions; in connection with their visits to a patient cared for on a ventilator while conscious and approximately a week after the end of intensive care. The data were analysed by means of hermeneutic interpretation to obtain a deeper understanding of relatives' experiences.

RESULTS

Striving to achieve contact with the patient was the most important aspect of being a close relative of a patient receiving ventilator treatment while conscious and was described by four main themes: feeling ambivalent towards consciousness; feeling ambivalent towards sedation; feeling dependent on the carer and being disappointed; and suppressing own suffering and sadness.

CONCLUSION

The patients' consciousness enabled the relatives to judge their condition for themselves and enter into contact. This resulted in a sense of being in control but also efforts to suppress own suffering.

摘要

背景

近年来,对呼吸窘迫的患者进行有创机械通气时,采用轻度镇静或无镇静已成为一种常见方法。但据我们所知,对于在 ICU 接受机械通气的清醒患者,探访者的体验尚未得到研究。

目的

本研究旨在描述亲属对与接受机械通气而有意识的患者会面、探视和交流的经历所赋予的意义。

方法

本研究采用前瞻性探索性设计,对十名亲属进行了两次访谈;一次是在患者接受机械通气清醒时探访后,另一次是在 ICU 结束后大约一周。通过解释学解释对数据进行分析,以更深入地了解亲属的经历。

结果

努力与患者建立联系是作为接受机械通气治疗的清醒患者的亲属最重要的方面,描述了四个主要主题:对意识感到矛盾;对镇静感到矛盾;对照顾者感到依赖和失望;以及抑制自己的痛苦和悲伤。

结论

患者的意识使亲属能够自行判断自己的状况并进行接触。这导致了一种控制感,但也努力抑制自己的痛苦。

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