Han Chin-Yen, Lin Chun-Chih, Goopy Suzanne, Hsiao Ya-Chu, Barnard Alan, Wang Li-Hsiang
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.
Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.
J Clin Nurs. 2017 Mar;26(5-6):840-848. doi: 10.1111/jocn.13621. Epub 2016 Dec 18.
To understand the experiences and concerns of patients in the emergency department during inpatient boarding.
Boarding in the emergency department is an increasingly common phenomenon worldwide. Emergency department staff, patients and their families become more stressed as the duration of boarding in the emergency department increases. Yet, there is limited knowledge of the experiences and concerns of boarded patients.
The qualitative approach of phenomenography was used in the study.
The phenomenographic study was conducted in one emergency department that treats approximately 15,000 patients each month. Twenty emergency department boarding patients were recruited between July-September 2014. Semi-structured interviews were used for data collection. The seven steps of qualitative data analysis for a phenomenographic study - familiarisation, articulation, condensation, grouping, comparison, labelling and contrasting - were employed to develop an understanding of participants' experiences and concerns during their inpatient boarding in the emergency department.
The perceptions that emerged from the data were collected into four categories of description of the phenomenon of emergency department boarding patients: a helpless choice; loyalty to specific hospitals and doctors; an inevitable challenge of life; and distrust of the healthcare system. The outcome space for the emergency department boarding patients was waiting and hoping for a cure.
The experiences and concerns of emergency department boarding patients include physical, psychological, spiritual and health system dimensions. It is necessary to develop an integrated model of care for these patients.
Understanding the experiences and concerns of patients who are placed on boarding status in the ED will help emergency healthcare professionals to improve the quality of emergency care. There is a need to develop a care model and associated intervention measures for emergency department patients during the boarding process. The results of this study will help health regulatory authorities to develop an appropriate emergency department boarding system so that patients receive better emergency care.
了解住院待床期间急诊科患者的经历与担忧。
急诊科待床在全球范围内日益普遍。随着急诊科待床时间的增加，急诊科工作人员、患者及其家属的压力越来越大。然而，对于待床患者的经历和担忧了解有限。
本研究采用现象学的质性研究方法。
在一个每月接待约15000名患者的急诊科进行现象学研究。2014年7月至9月招募了20名急诊科待床患者。采用半结构式访谈收集数据。运用现象学研究质性数据分析的七个步骤——熟悉、表述、浓缩、分组、比较、标注和对比——来了解参与者在急诊科住院待床期间的经历和担忧。
从数据中得出的认知被归纳为急诊科待床患者现象的四类描述：无奈的选择；对特定医院和医生的忠诚；生活中不可避免的挑战；以及对医疗系统的不信任。急诊科待床患者的结果空间是等待并期望治愈。
急诊科待床患者的经历和担忧包括身体、心理、精神和医疗系统层面。有必要为这些患者制定综合护理模式。
了解急诊科待床患者的经历和担忧将有助于急诊医护人员提高急诊护理质量。有必要为急诊科待床患者制定护理模式及相关干预措施。本研究结果将有助于卫生监管部门制定合适的急诊科待床系统，以便患者获得更好的急诊护理。
