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一项关于临终关怀机构中护理人员对谵妄体验的定性研究。

A qualitative study of nursing staff experiences of delirium in the hospice setting.

作者信息

Waterfield Kerry, Weiand Donna, Dewhurst Felicity, Kiltie Rachel, Pickard Jonathan, Karandikar Ulka, MacCormick Fiona, Vidrine Jen, Rowley Grace, Coulter Paul, Lee Mark, Frew Katie

机构信息

Specialty trainees, Palliative Medicine, Health Education North East, UK.

Consultant, Palliative Medicine, Queen Elizabeth Hospital, Gateshead.

出版信息

Int J Palliat Nurs. 2018 Nov 2;24(11):524-534. doi: 10.12968/ijpn.2018.24.11.524.

Abstract

BACKGROUND

: Delirium is a common condition occurring in 13-42% of people admitted to palliative care units and up to 88% of these patients are at the end of their lives. It is frequently unrecognised and distressing to all those affected-patients, families and health professionals. In addition, there is considerable uncertainty surrounding its trajectory and optimal management, both of which can be inconsistent.

AIMS

: This study aims to explore the experience of nursing staff who are caring for patients with delirium in the hospice environment and understand any potential barriers to its management.

METHODS

: Semistructured interviews using emotional touchpoints were conducted with 12 nurses and six healthcare assistants in three hospices in North East England. Data was analysed using interpretative phenomenological analysis.

FINDINGS

: The results highlighted gaps in knowledge and understanding in the management of delirium. The results demonstrated delirium had significant emotional effects, which were associated with uncertainty in managing the condition and the impact of this uncertainty on the relationship between staff and patients.

CONCLUSION

: This study highlights the emotional impact of caring for patients with delirium. Future work is needed to address the areas of uncertainty identified and ascertain how to best support nursing staff in these challenges.

摘要

背景

谵妄是一种常见病症,在入住姑息治疗病房的患者中发生率为13% - 42%,其中高达88%的患者已处于生命末期。它常常未被识别,且会给所有受影响的人——患者、家属和医护人员带来痛苦。此外,关于其病程和最佳管理存在相当大的不确定性,这两者可能都不一致。

目的

本研究旨在探索在临终关怀环境中照顾谵妄患者的护理人员的经历,并了解其管理的任何潜在障碍。

方法

对英格兰东北部三家临终关怀机构的12名护士和6名医疗辅助人员进行了使用情感接触点的半结构式访谈。采用解释性现象学分析对数据进行分析。

结果

结果凸显了在谵妄管理方面知识和理解上的差距。结果表明谵妄具有显著的情感影响,这与管理病情的不确定性以及这种不确定性对医护人员与患者关系的影响有关。

结论

本研究突出了照顾谵妄患者的情感影响。未来需要开展工作来解决已确定的不确定性领域,并确定如何在这些挑战中最好地支持护理人员。

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