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“帷幕之后发生了什么?”对重症监护病房护士在为重症监护病房死亡患者提供临终护理方面的经历的探索。

"What happens behind the curtains?" An exploration of ICU nurses' experiences of post mortem care on patients who have died in intensive care.

作者信息

de Swardt Carien, Fouché Nicola

机构信息

Clinical Department, University of Cape Town Private Academic Hospital, Cape Town, Observatory 7925, South Africa.

Department Health and Rehabilitation Sciences, University of Cape Town, Observatory 7925, South Africa.

出版信息

Intensive Crit Care Nurs. 2017 Dec;43:108-115. doi: 10.1016/j.iccn.2017.05.005. Epub 2017 Jun 7.

Abstract

THE AIM OF THE STUDY

The aim of this study was to explore the experiences of intensive care nurses performing post mortem care on patients who had died in an intensive care unit at a private hospital in Cape Town. The study further sets out to identify educational needs and to offer recommendations that may address these needs for this sample of nurses.

METHODOLOGY AND SETTING

A qualitative research design using a descriptive method was used to explore the experiences of a purposive heterogeneous sample of six nurses who were working in an intensive care unit in a private hospital in Cape Town.

DATA COLLECTION AND ANALYSIS

A semi-structured interview which was audio-taped and transcribed verbatim was employed to collect data. Colaizzi's (1978) seven step inductive method was used to formulate naïve themes. Following participant feedback, three main themes emerged: care of the dead body, detachment and thanatophobia.

FINDINGS

Safeguarding the integrity and physical appearance of the dead body was the major finding and of the utmost priority for the participants in this study. Regardless of how the nurses felt about death, providing professional and quality care to the dead body and the family was seen as significantly important. The nurses, whilst performing post mortem care, experienced detachment from various relationships. This comprised of the nurse detaching him/herself professionally and emotionally from the dead patient, the family and him/herself from the death experience. This 'unspoken' experience of thanatophobia became apparent when the nurses were confronted by the reality of their own deaths.

CONCLUSION AND RECOMMENDATIONS

In a technological society, where answers to many questions can be pursued through science, understanding the experience of death, as opposed to dying, may be logically incomprehensible. Death remains one of the most traumatic events experienced by the patient and their family, and in some instances nurses themselves. The study has drawn attention to the nurses' experiences and in doing so; the emotional and educational needs have been identified, and in part, pedagogical offerings are recommended.

摘要

研究目的

本研究旨在探究在开普敦一家私立医院重症监护病房工作的护士为在该病房死亡的患者提供尸体护理的经历。该研究还进一步着手确定教育需求,并针对该样本护士提出可能满足这些需求的建议。

方法与背景

采用描述性定性研究设计,以探究在开普敦一家私立医院重症监护病房工作的六名护士这一有目的的异质样本的经历。

数据收集与分析

采用半结构化访谈,进行录音并逐字转录以收集数据。运用科莱齐(1978年)的七步归纳法来形成初始主题。根据参与者的反馈,出现了三个主要主题:尸体护理、超脱和死亡恐惧。

研究结果

维护尸体的完整性和外观是本研究参与者的主要发现和最优先事项。无论护士对死亡的感受如何,为尸体和家属提供专业且高质量的护理都被视为非常重要。护士在进行尸体护理时,经历了与各种关系的超脱。这包括护士在职业和情感上与死亡患者、家属脱离,以及自身与死亡经历脱离。当护士面对自己死亡的现实时,这种“未言明”的死亡恐惧体验就变得明显了。

结论与建议

在一个可以通过科学追求许多问题答案的技术社会中,理解死亡的体验而非濒死体验,从逻辑上讲可能难以理解。死亡仍然是患者及其家属,在某些情况下也是护士自己所经历的最具创伤性的事件之一。该研究关注了护士的经历,通过这样做,确定了情感和教育需求,并部分推荐了教学内容。

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