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本科护生在临床环境中接触阿片类药物使用障碍患者的体验和态度:定性内容分析。

Undergraduate nursing students' experiences and attitudes towards working with patients with opioid use disorder in the clinical setting: A qualitative content analysis.

机构信息

University of Vermont, USA.

MedStar Georgetown University Hospital, USA.

出版信息

Nurse Educ Today. 2019 Feb;73:17-22. doi: 10.1016/j.nedt.2018.11.001. Epub 2018 Nov 9.

Abstract

BACKGROUND

With the US facing an opioid epidemic, undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Yet, nursing curriculums have not adapted to meet this need. Previous research indicates students are exposed to negative messages that might influence their views about patients with opioid use disorder.

OBJECTIVES

The purpose of this study was to examine nursing students' experiences encountering patients with opioid use disorder in the clinical setting, their attitudes about their encounters, and their perceptions of their educational preparedness to care for this population.

METHOD

Purposive sampling was used to identify participants. Semi-structured interviews were conducted until saturation. Krippendorff's method for qualitative content analysis was used to cluster units within the data to identify emergent themes.

PARTICIPANTS

Eleven senior nursing students from a public university in New England participated.

RESULTS

Analysis revealed six themes, including: navigating ethical dilemmas, gaining comfort with time and experience, avoiding the "elephant in the room," learning from real-world scenarios, witnessing discriminatory care, and recognizing bias and stigma.

CONCLUSIONS

Students were most likely to experience bias and internal conflict in maternity clinical rotations. Education should include practical communication strategies to reduce avoidance behaviors among nursing students as well as techniques to manage difficult situations and reduce moral distress. Nurses must be mindful of their power to influence students and should model non-judgmental language and behavior. Students ultimately expressed a desire to provide informed and empathetic care.

摘要

背景

随着美国面临阿片类药物泛滥的问题,本科护理专业的学生在临床环境中越来越多地遇到患有阿片类药物使用障碍的患者。然而,护理课程并没有适应这一需求。先前的研究表明,学生接触到的负面信息可能会影响他们对患有阿片类药物使用障碍患者的看法。

目的

本研究旨在探讨护理专业学生在临床环境中遇到患有阿片类药物使用障碍患者的经历、他们对这些遭遇的态度,以及他们对护理这一人群的教育准备情况的看法。

方法

采用目的抽样法确定参与者。进行半结构化访谈,直到达到饱和。采用克里普多夫的定性内容分析方法对数据中的单位进行聚类,以确定出现的主题。

参与者

11 名来自新英格兰一所公立大学的高年级护理专业学生参加了研究。

结果

分析结果揭示了六个主题,包括:应对伦理困境、通过时间和经验获得舒适感、避免“房间里的大象”、从现实场景中学习、目睹歧视性护理、以及认识到偏见和耻辱。

结论

学生在妇产科临床实习中最有可能经历偏见和内心冲突。教育应包括实用的沟通策略,以减少护理专业学生的回避行为,并提供处理困难情况和减轻道德困境的技巧。护士必须注意自己对学生的影响力,并应树立非评判性的语言和行为榜样。学生最终表示希望提供知情和富有同情心的护理。

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