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患者和护士对谵妄的体验:定性研究综述。

Patients' and nurses' experiences of delirium: a review of qualitative studies.

机构信息

University of Montreal, Chemin Queen-Mary, Québec, Canada.

出版信息

Nurs Crit Care. 2011 Nov-Dec;16(6):303-15. doi: 10.1111/j.1478-5153.2011.00454.x. Epub 2011 Jul 19.

Abstract

BACKGROUND

Knowledge of delirium accumulated over the past two decades has focused more on its characteristics, pathophysiology, incidence, aetiology and prognosis as well as interventions for preventing, detecting, evaluating or managing this syndrome and less so on how patients and nurses who care for them experience it.

AIMS

To present the state of knowledge derived from qualitative studies of the experiences of persons who suffered delirium and of nurses who cared for them to guide critical care practice.

RESULTS

Delirious patients experience incomprehension and various feelings of discomfort. Understanding, support, believing what they are experiencing, explanations, the presence of family/friends and the possibility of talking about the lived experience are interventions that might help them get through such episodes more easily. Nurses who tend to delirious patients fail to comprehend the utterances and behaviours of the persons cared for and experience various feelings of discomfort as well. Nevertheless, they intervene following different goals and intervention strategies that seem to vary as a function of their culture and values.

CONCLUSION

Qualitative studies conducted on persons who suffered delirium and on nurses who cared for them have shed light on their lived experience and provide insight on how to improve critical care practice.

RELEVANCE TO CLINICAL PRACTICE

The findings suggest that nurses must acknowledge the lived experience of the persons cared for and they must seek out the meaning that patients ascribe to this experience to understand the situation and thus conduct interventions that meet the needs expressed.

摘要

背景

过去二十年来,人们对谵妄的认识越来越多,重点关注其特征、病理生理学、发病率、病因和预后,以及预防、检测、评估或管理这种综合征的干预措施,而对患者和护理他们的护士的体验关注较少。

目的

介绍从经历过谵妄的患者和护理他们的护士的定性研究中得出的知识状态,以指导重症监护实践。

结果

谵妄患者体验到困惑和各种不适的感觉。理解、支持、相信他们所经历的事情、解释、家人/朋友的存在以及谈论生活经历的可能性,这些干预措施可能有助于他们更容易地度过这些阶段。照顾谵妄患者的护士也无法理解被照顾者的言语和行为,并体验到各种不适的感觉。然而,他们根据不同的目标和干预策略进行干预,这些策略似乎因文化和价值观的不同而有所不同。

结论

对经历过谵妄的患者和照顾他们的护士进行的定性研究揭示了他们的生活体验,并提供了关于如何改进重症监护实践的见解。

临床实践的相关性

研究结果表明,护士必须承认被照顾者的生活体验,他们必须寻找患者赋予这种体验的意义,以了解情况,从而进行满足表达需求的干预措施。

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