Kongsuwan Waraporn, Matchim Yaowarat, Nilmanat Kittikorn, Locsin Rozzano C, Tanioka Tetsuya, Yasuhara Yuko
Medical Nursing Department, Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Faculty of Nursing, Thammasat University, Thailand.
Int Nurs Rev. 2016 Mar;63(1):132-8. doi: 10.1111/inr.12234. Epub 2016 Jan 8.
Dying often occurs in hospitals and frequently in emergency rooms. Understanding caring for critical and dying patients is necessary for quality nursing.
This study described the meaning of nurses' lived experience of caring for critical and dying patients in the emergency rooms.
This study was conducted in three emergency rooms of tertiary hospitals in southern Thailand. Twelve nurses met the inclusion criteria: nurses working in emergency room for at least 2 years, and experienced caring for critical and dying patients in an emergency department. Data were collected using in-depth individual interviews. Data transcription and analysis used van Manen's hermeneutic phenomenological approach. Trustworthiness was established following Lincoln and Guba's criteria.
Experiences of caring for critical and dying patients revealed four thematic categories: defying death; no time for palliative care; lacking support for family; and privacy for peaceful deaths. These thematic categories reflected van Manen's four lived worlds of body, time, relations and space.
The study described the meaning of the experience of caring for critical and dying patients while supporting the development of nursing knowledge for palliative and end-of-life care in emergent settings.
Findings of the study influence nursing policies toward enhancing education of nurses regarding palliative and end-of-life care in emergency settings. These findings can also influence the value of caring-healing environments for critical and dying patients and their families. Policies can focus on practice and education of families particularly about end-of-life care for critical and dying patients.
死亡常常发生在医院，尤其是急诊室。理解对重症和临终患者的护理对于高质量护理至关重要。
本研究描述了护士在急诊室护理重症和临终患者的生活经历的意义。
本研究在泰国南部三家三级医院的急诊室进行。12名护士符合纳入标准：在急诊室工作至少2年，且有在急诊科护理重症和临终患者的经验。采用深度个人访谈收集数据。数据转录和分析采用范曼的诠释现象学方法。依据林肯和古巴的标准建立可信度。
护理重症和临终患者的经历揭示了四个主题类别：与死亡抗争；无暇进行姑息治疗；缺乏对家属的支持；以及为安详离世提供隐私。这些主题类别反映了范曼的身体、时间、关系和空间四个生活世界。
本研究描述了护理重症和临终患者经历的意义，同时支持了急诊环境中姑息和临终护理的护理知识发展。
该研究结果影响护理政策，以加强护士在急诊环境中关于姑息和临终护理的教育。这些结果还可影响重症和临终患者及其家属护理康复环境的价值。政策可侧重于家庭的实践和教育，特别是关于重症和临终患者的临终护理。
