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对急症护理护士护理智障患者经历的叙述性综述:准备不足、沟通障碍以及护理人员角色的模糊性。

A narrative review of acute care nurses' experiences nursing patients with intellectual disability: underprepared, communication barriers and ambiguity about the role of caregivers.

作者信息

Lewis Peter, Gaffney Ryan J, Wilson Nathan J

机构信息

School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia.

School of Nursing and Midwifery, Ingham Institute for Applied Medical Research, Western Sydney University, Richmond, NSW, Australia.

出版信息

J Clin Nurs. 2017 Jun;26(11-12):1473-1484. doi: 10.1111/jocn.13512. Epub 2017 Feb 8.

Abstract

AIMS AND OBJECTIVES

To describe how nurses experience caring for people with intellectual disability in an acute care setting.

BACKGROUND

Recent advances in the care of people with intellectual disability in hospital are primarily based upon the experiences of people with intellectual disability and their caregivers. Little is known about the experiences of registered nurses caring for people with intellectual disability, yet the experiences of nurses in delivering care largely determine the quality of care experienced by people with intellectual disability and their caregivers.

METHODS

A narrative literature review using electronic database searches was conducted using variants of the terms disability, nursing and acute care.

RESULTS

Through our reading of the recent literature describing the experiences of nurses caring for people with intellectual disability in an acute care setting, we have identified three themes: (1) nurses feel underprepared when caring for patients with intellectual disability, (2) nurses experience challenges when communicating with people with intellectual disability and (3) nurses have ambiguous expectations of paid and unpaid caregivers.

CONCLUSION

The enablers of and barriers to the delivery of nursing care in acute care settings need to be made explicit and researchers and nurses need to collaborate in the development, implementation and evaluation of care delivery strategies.

RELEVANCE TO CLINICAL PRACTICE

Nurses need to be adequately prepared to care for people with intellectual disability. Preparation should include dealing with the complexities of communicating with people with intellectual disability and practical experience of doing so in clinical and educational environments that ensure the safety and dignity of nurses and people with intellectual disability. Nurses need supportive strategies for developing therapeutic relationships with a range of informal and formal caregivers.

摘要

目的与目标

描述护士在急症护理环境中护理智障人士的经历。

背景

医院中智障人士护理的最新进展主要基于智障人士及其照顾者的经历。对于注册护士护理智障人士的经历知之甚少,然而护士在提供护理时的经历在很大程度上决定了智障人士及其照顾者所体验到的护理质量。

方法

使用电子数据库搜索,对术语“残疾”“护理”和“急症护理”的变体进行叙述性文献综述。

结果

通过阅读近期描述护士在急症护理环境中护理智障人士经历的文献,我们确定了三个主题:(1)护士在护理智障患者时感到准备不足;(2)护士在与智障人士沟通时遇到挑战;(3)护士对有偿和无偿照顾者的期望不明确。

结论

需要明确急症护理环境中提供护理的促进因素和障碍,研究人员和护士需要在护理提供策略的制定、实施和评估方面进行合作。

与临床实践的相关性

护士需要做好充分准备来护理智障人士。准备工作应包括应对与智障人士沟通的复杂性,以及在确保护士和智障人士安全与尊严的临床和教育环境中进行此类沟通的实践经验。护士需要支持性策略来与一系列非正式和正式照顾者建立治疗性的关系。

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