Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Department of Surgey, Höglandssjukhuset Eksjö, Eksjö, Sweden.
J Clin Nurs. 2018 Jun;27(11-12):2311-2321. doi: 10.1111/jocn.14095. Epub 2017 Dec 6.
To explore the delivery of care from the perspective of patients with acute abdominal pain focusing on the contextual factors at system level using the Fundamentals of Care framework.
The Fundamentals of Care framework describes several contextual and systemic factors that can impact the delivery of care. To deliver high-quality, person-centred care, it is important to understand how these factors affect patients' experiences and care needs.
A focused ethnographic approach.
A total of 20 observations were performed on two surgical wards at a Swedish university hospital. Data were collected using participant observation and informal interviews and analysed using deductive content analysis.
The findings, presented in four categories, reflect the value patients place on the caring relationship and a friendly atmosphere on the ward. Patients had concerns about the environment, particularly the high-tempo culture on the ward and its impact on their integrity, rest and sleep, access to information and planning, and need for support in addressing their existential thoughts. The observers also noted that missed nursing care had serious consequences for patient safety.
Patients with acute abdominal pain were cared for in the high-tempo culture of a surgical ward with limited resources, unclear leadership and challenges to patients' safety. The findings highlight the crucial importance of prioritising and valuing the patients' fundamental care needs for recovery.
Nursing leaders and nurses need to take the lead to reconceptualise the value of fundamental care in the acute care setting. To improve clinical practice, the value of fundamentals of care must be addressed regardless of patient's clinical condition. Providing a caring relationship is paramount to ensure a positive impact on patient's well-being and recovery.
本研究旨在从急性腹痛患者的角度出发，利用护理基本要素框架探讨系统层面的护理服务，重点关注情境因素。
护理基本要素框架描述了几个可能影响护理服务提供的情境和系统因素。为了提供高质量、以患者为中心的护理，了解这些因素如何影响患者的体验和护理需求至关重要。
采用聚焦民族志方法。
在瑞典一所大学医院的两个外科病房共进行了 20 次观察。数据收集采用参与式观察和非正式访谈，使用演绎内容分析法进行分析。
研究结果呈现为四个类别，反映了患者对护理关系和病房友好氛围的重视。患者对环境表示担忧，特别是对病房的快节奏文化及其对他们完整性、休息和睡眠、信息获取和计划以及应对存在性思维需求的支持的影响。观察者还注意到，护理疏忽对患者安全产生了严重后果。
急性腹痛患者在外科病房的快节奏文化中接受治疗，资源有限，领导力不明确，患者安全面临挑战。研究结果强调了优先考虑和重视患者基本护理需求对康复的重要性。
护理领导者和护士需要带头重新构想急性护理环境中基本护理的价值。为了改善临床实践，无论患者的临床状况如何，都必须解决基本护理要素的价值。提供关怀关系至关重要，以确保对患者的幸福感和康复产生积极影响。
