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自焚患者护理中遗漏了什么?一项扎根理论研究。

What is missed in self-immolated patients' care? A grounded theory study.

机构信息

Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran.

出版信息

J Clin Nurs. 2012 Dec;21(23-24):3418-28. doi: 10.1111/jocn.12006.

Abstract

AIMS AND OBJECTIVES

To explore rehabilitation care process in patients who commit self-immolation.

BACKGROUND

Self-immolation is not only a type of burn injury, but it is also a suicidal method. It is placed in burn injury category that requires long-term rehabilitation and treatment measures. As a suicidal method, among all forms of suicidal attempts, it is the most dramatic, violent and often difficult one to understand. Unfortunately, there are few reported studies investigating experiences and perceptions of nurses about burn care and with qualitative study about the patients' experiences and perceptions.

DESIGN

On the basis of the research question, the grounded theory method was used.

METHODS

Considering ethical codes of Belmont and Helsinki statements, purposive sampling was used to select the participants. The patients were deliberately selected, based on the research needs. They were self-immolated patients being referred to Talaghani hospital of Ilam (western Iran) or discharged previously (time of interview and observation ranged from immediately later the burn till 5 years after), in Ilam, where self-immolation rate is very high. The main methods for data collection were deep, open ended, semi-structured interviews, dairies and observations. The interviews were audio taped in Persian, and verbatim transcriptions were made. By doing so, semantic meaning is preserved, and misinterpretation of data due to translation into English is minimised. Data analysis was conducted using the Strauss and Corbin method.

RESULTS

Five main categories were emerged: situation of crisis unprofessional care, prolongation and formidability of the journey, self-immolation as paralyse, and attempt for self-management. Finally, by constant, comparison of collected data and emerged categories, central variable entitled unintegrated care emerged as the main problem of self-immolated patients' care.

CONCLUSION

The study comes to the conclusion that we need to focus on specific considerations to provide integrated care for the burned patients as it is a decisive component of care that is missed.

RELEVANCE TO CLINICAL PRACTICE

Although self-immolation requires long-term treatment and social, emotional rehabilitation, such a rehabilitation care process is not clear.

摘要

目的和目标

探索自我伤害患者的康复护理过程。

背景

自我伤害不仅是一种烧伤类型,也是一种自杀方式。它被归入烧伤类别,需要长期的康复和治疗措施。作为一种自杀方式,在所有形式的自杀尝试中,自我伤害是最具戏剧性、最暴力、往往也最难理解的一种。不幸的是,很少有研究报告调查护士对烧伤护理的经验和看法,也没有关于患者经验和看法的定性研究。

设计

基于研究问题,采用扎根理论方法。

方法

考虑到贝尔蒙特和赫尔辛基宣言的伦理准则,采用目的抽样选择参与者。根据研究需要,有针对性地选择患者。这些患者是被故意挑选的,他们是以前被送到拉兰尼医院(伊朗西部伊拉姆)或以前出院(采访和观察时间从烧伤后立即到烧伤后 5 年不等)的自我伤害者,在伊拉姆,自我伤害率非常高。数据收集的主要方法是深入、开放式、半结构化访谈、日记和观察。访谈以波斯语录音,并制作逐字记录。这样做可以保留语义意义,并最大限度地减少因翻译成英语而导致的数据误解。使用 Strauss 和 Corbin 方法进行数据分析。

结果

出现了五个主要类别:危机情况下的非专业护理、旅程的延长和可怕、自我伤害作为瘫痪、以及自我管理的尝试。最后,通过不断比较收集的数据和出现的类别,中央变量“不整合的护理”被确定为自我伤害患者护理的主要问题。

结论

该研究得出结论,我们需要关注具体的考虑因素,为烧伤患者提供综合护理,因为这是护理中缺失的决定性组成部分。

临床相关性

尽管自我伤害需要长期的治疗和社会、情感康复,但这种康复护理过程并不明确。

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