Kentischer Felix, Kleinknecht-Dolf Michael, Spirig Rebecca, Frei Irena Anna, Huber Evelyn
Center for Surgery, Medical Center, University of Freiburg, Freiburg, Germany.
Institute of Nursing Science, University of Basel, Basel, Switzerland.
Scand J Caring Sci. 2018 Mar;32(1):204-212. doi: 10.1111/scs.12449. Epub 2017 May 5.
Patient-related complexity of nursing care in acute care hospitals has increased in recent years, in part due to shorter hospital stays and the increase in multimorbid patients. However, little research has been conducted on how nurses experience complex nursing care situations.
The aim of this study was to gain a better understanding of how nurses experience complex nursing care situations in Swiss acute care hospitals.
This qualitative study utilised focus group interviews and thematic analysis. Focus groups facilitate different perspectives of the topic. Thematic analysis is suitable for the analysis of everyday stories. Participants were 24 Registered Nurses with experience in their field, from four Swiss hospitals. The evaluation was performed in six steps according to themes. Participation was voluntary. This study was part of a multicentre research project that had been approved by the responsible ethics committees.
Three main themes regarding the experience of complex nursing care situations were found: complexity as a challenge, complexity as an overwhelming burden and mediating factors. Mediating factors included time resources and teamwork and interprofessional collaboration as contextual conditions. Additionally, nurses' individual characteristics such as their professional experience and expertise, as well as their personal and professional values and beliefs were considered as mediating factors. These mediating factors may determine whether complex nursing care situations are experienced as challenging or overwhelming.
The findings from this study are limited as only experienced nurses participated in the study.
Nurses are ambivalent with regard to how they experience complex nursing care situations. The contextual conditions and the nurses' personal characteristics play a key role in whether nurses perceive complex nursing care situations as positive challenges or overwhelming burdens. These findings are important for managers, as they can support nurses to master complex nursing care situations.
近年来，急症医院中与患者相关的护理复杂性有所增加，部分原因是住院时间缩短以及多病共存患者数量增多。然而，关于护士如何体验复杂护理情况的研究较少。
本研究的目的是更好地了解瑞士急症医院的护士如何体验复杂护理情况。
这项定性研究采用焦点小组访谈和主题分析。焦点小组有助于从不同角度探讨该主题。主题分析适用于分析日常故事。参与者为来自瑞士四家医院的24名有该领域经验的注册护士。根据主题分六个步骤进行评估。参与是自愿的。本研究是一个多中心研究项目的一部分，该项目已获负责的伦理委员会批准。
发现了关于复杂护理情况体验的三个主要主题：复杂性作为挑战、复杂性作为压倒性负担以及中介因素。中介因素包括时间资源、团队合作以及作为背景条件的跨专业协作。此外，护士的个人特征，如专业经验和专业知识，以及他们的个人和职业价值观与信念也被视为中介因素。这些中介因素可能决定复杂护理情况被体验为具有挑战性还是压倒性。
本研究的结果有限，因为只有经验丰富的护士参与了研究。
护士对于如何体验复杂护理情况持矛盾态度。背景条件和护士的个人特征在护士将复杂护理情况视为积极挑战还是压倒性负担方面起着关键作用。这些发现对管理人员很重要，因为他们可以支持护士应对复杂护理情况。
