Bibi Shareena, Rasmussen P, McLiesh P
Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.
Adelaide Nursing School, University of Adelaide, Australia.
Int J Orthop Trauma Nurs. 2018 Aug;30:31-38. doi: 10.1016/j.ijotn.2018.05.002. Epub 2018 May 15.
Nurses are involved in delivering care for patients following acute traumatic spinal cord injury throughout the entire care journey. An injury of this type is significant for the individual and their family and can be challenging for nurses delivering care for patients with life changing injuries, especially for nurses new to this setting. There is a lack of research that examines the experience of nurses caring for these patients in the acute setting.
A hermeneutic phenomenological approach was used to understand the experience of nurses caring for patients in the acute setting who had sustained a traumatic spinal injury with associated neurological deficit. Using the phenomenological approach guided by the insight of Gadamer and Max Van Manen, participants with a broad range of experience were recruited and interviewed. The responses were transcribed into a text and subjected to hermeneutic analysis. Burnard's (1991) 14-step process and the hermeneutic approach were used to interpret and understand the phenomenon of interest.
The study highlights the experience and challenges of providing care to these individuals. Although patients had significant physical disabilities and were often dependent physically, the nurses' concerns were directed more towards fulfilling their psychological needs. Nurses identified grieving patients and felt their role was to provide realistic hope to motivate them. They felt an internal tension regarding desensitisation towards their patients, but this was often an internal protective mechanism to deal with the significance of the events surrounding these patients. Nurses new to this setting took time to learn the routines and manage the unique challenges effectively. Caring for these patients gave the nurses the opportunity to understand their patients and their families, and appreciate that both groups will fluctuate in their behavior throughout the acute process, as they adjust to grief and loss.
在整个护理过程中，护士都参与为急性创伤性脊髓损伤患者提供护理。这种类型的损伤对患者及其家庭意义重大，对于为有改变生活损伤的患者提供护理的护士来说可能具有挑战性，尤其是对于初涉此领域的护士。目前缺乏研究来考察护士在急性护理环境中照顾这些患者的经历。
采用诠释现象学方法来理解护士在急性护理环境中照顾遭受创伤性脊髓损伤并伴有神经功能缺损患者的经历。在伽达默尔和马克斯·范·曼嫩的见解指导下，采用现象学方法，招募了具有广泛经验的参与者并进行访谈。访谈内容被转录成文本并进行诠释分析。使用伯纳尔德（1991年）的14步流程和诠释方法来解释和理解感兴趣的现象。
该研究突出了为这些患者提供护理的经历和挑战。尽管患者有严重的身体残疾且通常在身体上依赖他人，但护士的关注点更多地指向满足他们的心理需求。护士识别出悲伤的患者，并认为自己的角色是提供现实的希望以激励他们。他们在对患者脱敏方面感到内心有张力，但这往往是一种内在的保护机制，用于应对围绕这些患者的事件的重要性。初涉此领域的护士需要时间来学习常规并有效应对独特的挑战。照顾这些患者让护士有机会了解患者及其家人，并认识到这两个群体在整个急性过程中，随着他们适应悲伤和失落，行为都会有所波动。
