Chen Cassandra Siyun, Chan Sally Wai-Chi, Chan Moon Fai, Yap Suk Foon, Wang Wenru, Kowitlawakul Yanika
1BSc, RN, Department of Nursing, Khoo Teck Puat Hospital, Singapore 2PhD, RN, FAAN, Professor and Head of School, School of Nursing and Midwifery, University of Newcastle, Australia 3MN, APN, Advanced Practice Nurse, Department of Nursing, Khoo Teck Puat Hospital, Singapore 4PhD, Associate Professor, Lui Che Woo College, University of Macau, China 5PhD, RN, Assistant Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 6PhD, RN, Assistant Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
J Nurs Res. 2017 Dec;25(6):411-418. doi: 10.1097/JNR.0000000000000185.
Psychosocial care is the culturally sensitive provision of psychological, social, and spiritual care through therapeutic communication. Current evidence suggests that effective psychosocial care improves patients' health outcomes and quality of life.
The aim of this study was to explore nurses' perceptions and experiences in providing psychosocial care to patients and to identify the related barriers and challenges.
An exploratory qualitative design using semistructured, individual, face-to-face interviews was adopted. A purposive sample of 18 registered nurses was recruited from the geriatric, medical, and surgical wards in an acute general hospital in Singapore. Interviews were audio-recorded, transcribed, and analyzed thematically.
Four major themes emerged: patient-centered care, communication, interprofessional care, and barriers to psychosocial care. Nurses perceived that psychosocial care consists of providing holistic care, spiritual care, support to the patient and family members, and showing empathy. Furthermore, psychosocial care is composed of communication between nurses and the patient and family members as well as communication among nurses. In addition, psychosocial care involves collaboration between healthcare professionals as well as multidisciplinary care. Barriers that are perceived by nurses include lack of time, language barriers, being task-oriented, excessive documentation, lack of family involvement, and fear of complaints.
This study highlighted the perceptions of nurses regarding psychosocial care and the challenges in providing this care. Future studies are needed to explore ways to overcome these barriers and to enhance nurses' competencies in providing psychosocial care. The findings indicate a need to plan future interventions to provide nurses with both skill development and support to improve their ability to integrate psychosocial care, which will improve patient outcomes.
心理社会护理是通过治疗性沟通提供的具有文化敏感性的心理、社会和精神护理。目前的证据表明，有效的心理社会护理可改善患者的健康结局和生活质量。
本研究的目的是探讨护士在为患者提供心理社会护理方面的认知和经验，并确定相关的障碍和挑战。
采用探索性定性设计，通过半结构化的个人面对面访谈进行。从新加坡一家急症综合医院的老年科、内科和外科病房中选取了18名注册护士作为目的抽样样本。访谈进行了录音、转录并进行了主题分析。
出现了四个主要主题：以患者为中心的护理、沟通、跨专业护理以及心理社会护理的障碍。护士们认为心理社会护理包括提供整体护理、精神护理、对患者及其家属的支持以及表达同理心。此外，心理社会护理由护士与患者及其家属之间的沟通以及护士之间的沟通组成。此外，心理社会护理涉及医疗保健专业人员之间的合作以及多学科护理。护士们意识到的障碍包括时间不足、语言障碍、任务导向、过多的文件记录、家属参与不足以及对投诉的恐惧。
本研究突出了护士对心理社会护理的认知以及提供这种护理时面临的挑战。未来需要开展研究，探索克服这些障碍的方法，并提高护士提供心理社会护理的能力。研究结果表明需要规划未来的干预措施，为护士提供技能发展和支持，以提高他们整合心理社会护理的能力，从而改善患者的结局。
