Jakimowicz Samantha, Perry Lin
Faculty of Health, University of Technology, Sydney, New South Wales, Australia.
J Adv Nurs. 2015 Jul;71(7):1499-517. doi: 10.1111/jan.12644. Epub 2015 Feb 27.
To report an analysis of the concept of patient-centred nursing in the context of intensive care.
Clarification of patient-centred nursing in the intensive care unit is important because consensus definition of this concept is lacking. The severely compromised physiological state of these people and the sequelae of this differentiate patient-centred nursing in intensive care from that occurring in other hospital settings. While the broad concept has been analysed, it has not been examined in the context of intensive care.
Concept analysis.
CINAHL, PsycINFO, Medline and PubMed databases (2000-2014) were searched. Peer-reviewed papers were identified and reference lists of relevant articles searched.
Walker and Avant's eight-stage approach was used.
Patient-centred nursing in the intensive care unit incorporates antecedents of a physiologically compromised patient requiring biomedical intervention, a professional and competent nurse and organizational support. The concept's defining attributes entail maintenance of patient identity by a compassionate and professional nurse exercising biomedical expertise. Consequences include patient satisfaction, positive patient experience, nurse job satisfaction and better nurse workforce retention.
Patient-centred nursing in intensive care is differentiated from other healthcare areas by the particular characteristics of critically ill patients, the critical care environment and the challenging bio-psycho-social demands made on intensive care nurses. Effective patient-centred nursing in this environment promotes beneficial outcomes for patients, nurses and healthcare service. Decision-makers and policymakers should support critical care nurses in this challenging role, to maintain delivery of patient-centred nursing and grow an effective nursing workforce.
报告对重症监护环境下以患者为中心的护理概念的分析。
明确重症监护病房中以患者为中心的护理很重要，因为缺乏对这一概念的共识性定义。这些患者严重受损的生理状态及其后遗症，使得重症监护中的以患者为中心的护理有别于其他医院环境中的护理。虽然这一宽泛概念已被分析，但尚未在重症监护环境中进行审视。
概念分析。
检索了CINAHL、PsycINFO、Medline和PubMed数据库（2000 - 2014年）。确定了同行评审论文，并检索了相关文章的参考文献列表。
采用沃克和阿凡特的八阶段方法。
重症监护病房中以患者为中心的护理包含需要生物医学干预的生理受损患者、专业且称职的护士以及组织支持等前提条件。该概念的定义属性包括富有同情心且具备生物医学专业知识的护士维护患者身份。结果包括患者满意度、积极的患者体验、护士工作满意度以及更好地留住护士队伍。
重症监护中以患者为中心的护理因危重症患者的特殊特征、重症监护环境以及对重症监护护士提出的具有挑战性的生物 - 心理 - 社会需求，而有别于其他医疗领域。在这种环境下有效的以患者为中心的护理能为患者、护士和医疗服务带来有益结果。决策者和政策制定者应支持重症监护护士履行这一具有挑战性的职责，以维持以患者为中心的护理服务并培养一支高效的护理队伍。
