Foà Chiara, Cavalli Lisa, Maltoni Alessia, Tosello Nicoletta, Sangilles Chiara, Maron Ilaria, Borghini Marina, Artioli Giovanna
University Teaching Hospital, Parma, Italy.
Acta Biomed. 2016 Nov 22;87(4-S):71-82.
In an Intensive Care Unit (ICU) the communication between nurse and patient, the core of the care, is often hindered by patient's cognitive alterations and critical situation, by devices employed for the mechanical ventilation, and by the clinical and care-giving setting. How to overcome these barriers? How is the relational and communicative approach between nurse and patient unable to express him or herself to be managed? The available literature reveals that studies on communication with difficult patients, such as those treated in ICU are currently scarce.
The present research offers a contribution in this respect, through fact-finding about the knowledge acquired by professional studies or work experiences, the personal and institutional techniques implemented in regards to communication (knowledge of the work), the relational behaviours and the emotional experience with patients (knowledge of the emotional state) of nurses working in the Intensive Care Units. A semi-structured interview have been designed and submitted to 30 nurses working in fourteen Highly Specialized Centres (HUB) in Emilia Romagna, Italy. Two nurses with different years of experience in the field have been chosen for each Operating Unit.
According to the interviewees paraverbal communication is the most common way to communicate with patients: different strategies are employed such as facial expression or lip movement. In any case, the nurse has the task to choose the most suitable technique according to his or her experiences, his or her knowledge and the patient him or herself. The results claim that lack of specific training on communicative aspects of care, should be combined with an attitude of being prone to listening to and understanding the needs of the patient and of his or her family as well.
The interviewees declare they have a solid preparation in the bio-clinical aspect of care, but both new hired nurses and experts affirm that they need a specific training in relational and communicative aspects, proving its importance.
在重症监护病房(ICU)中,护理的核心——护士与患者之间的沟通,常常受到患者认知改变、危急状况、机械通气设备以及临床和护理环境的阻碍。如何克服这些障碍?对于无法表达自己的护士与患者之间的关系及沟通方式应如何处理?现有文献表明,目前关于与诸如在ICU接受治疗的这类难以沟通的患者进行沟通的研究较少。
本研究通过调查在重症监护病房工作的护士从专业学习或工作经验中获得的知识、在沟通方面实施的个人和机构技巧(工作知识)、与患者的关系行为以及情感体验(情绪状态知识),在这方面做出了贡献。设计了一份半结构化访谈,并提交给在意大利艾米利亚 - 罗马涅的14个高度专业化中心(HUB)工作的30名护士。为每个手术单元挑选了两名在该领域具有不同工作年限经验的护士。
根据受访者的说法,辅助语言沟通是与患者沟通最常用的方式:采用了不同的策略,如面部表情或嘴唇动作。无论如何,护士有任务根据自己的经验、知识以及患者自身情况选择最合适的技巧。结果表明,缺乏护理沟通方面的具体培训,应与倾向于倾听和理解患者及其家人需求的态度相结合。
受访者表示他们在护理的生物临床方面有扎实的准备,但新入职护士和专家都确认他们需要在关系和沟通方面接受特定培训,这证明了其重要性。