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中风后住院康复期间针对亲属的护理角色与功能。护理需求与参与情况。

Nursing roles and functions addressing relatives during in-hospital rehabilitation following stroke. Care needs and involvement.

作者信息

Aadal Lena, Angel Sanne, Langhorn Leanne, Pedersen Birgitte Blicher, Dreyer Pia

机构信息

Hammel Neurorehabilitation and Reseach Centre, Denmark.

Section for Nursing, Institute of Public Health, Aarhus University, Aarhus, Denmark.

出版信息

Scand J Caring Sci. 2018 Jun;32(2):871-879. doi: 10.1111/scs.12518. Epub 2017 Sep 4.

Abstract

RATIONALE

In the last decades, length of stay of in-hospital rehabilitation of patients with stroke has been significantly reduced. Health authorities expect relatives to be at disposal to convey the knowledge of everyday life and to provide emotional as well as practical support in relation to the patient. Caregivers require nurse assistance, support and to be seen as an essential partner in the care giving process. However, the nurses do not perceive that teaching of relatives is a task they should routinely undertake. This might indicate an ambiguity between the relatives' expectations and the actual contribution from nurses.

AIM

This study describes nurses' experienced roles and functions addressing the relatives of patients with stroke during in-hospital rehabilitation.

METHODOLOGICAL DESIGN

A phenomenological hermeneutic approach influenced by Paul Ricoeur. In a secondary analysis focus group, interviews of 19 randomly selected nurses from three different hospital settings were interpreted in three levels. The study was conducted in accordance with the ethical guidelines for nursing research in the Nordic countries.

FINDINGS

The nurses expressed that they address the patient and the relatives and support the interaction between the patient and the relatives. Four themes occurred: the changed lives of relatives; shared life after stroke; noncooperating relatives; time for the relatives.

CONCLUSION

Nurses experience their roles and functions addressing relatives after stroke as crucial, challenging and multifaceted. They acknowledged care needs of the relatives in their own right by addressing the relatives' vulnerability during in-hospital rehabilitation characterised by an existential threat to the physical as well as the shared life. The focus on the needs of relatives considering their expected future role was experienced as conflicting with restricting time frames and a healthcare system focusing on the individual patient.

摘要

理论依据

在过去几十年中,中风患者住院康复的住院时间已显著缩短。卫生当局期望亲属能够随时提供日常生活知识,并在患者方面提供情感和实际支持。护理人员需要护士的协助、支持,并被视为护理过程中的重要合作伙伴。然而,护士并不认为教导亲属是他们应常规承担的任务。这可能表明亲属的期望与护士的实际贡献之间存在模糊性。

目的

本研究描述了护士在住院康复期间针对中风患者亲属所扮演的角色和发挥的功能。

方法设计

受保罗·利科影响的现象学诠释学方法。在一项二次分析焦点小组研究中,对从三个不同医院环境中随机选取的19名护士的访谈进行了三个层面的解读。该研究是根据北欧国家护理研究的伦理准则进行的。

研究结果

护士表示他们关注患者及其亲属,并支持患者与亲属之间的互动。出现了四个主题:亲属生活的改变;中风后的共同生活;不合作的亲属;亲属的时间。

结论

护士认为他们在中风后针对亲属所扮演的角色和发挥的功能至关重要、具有挑战性且涉及多方面。他们通过在以身体和共同生活面临生存威胁为特征的住院康复期间关注亲属的脆弱性,认可了亲属自身的护理需求。考虑到亲属预期的未来角色而关注其需求,被认为与有限的时间框架以及专注于个体患者的医疗系统相冲突。

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