护理人员对其在照顾非医疗紧急相关心理健康和/或酒精及其他药物问题患者方面的实践范围的看法：一项定性研究。
Paramedics' perceptions of their scope of practice in caring for patients with non-medical emergency-related mental health and/or alcohol and other drug problems: A qualitative study.
机构信息
Department of Nursing and Midwifery, Institute of Health and Sport, Victoria University, Melbourne, Victoria, Australia.
Turning Point, Eastern Health, Melbourne, Victoria, Australia.
出版信息
PLoS One. 2018 Dec 13;13(12):e0208391. doi: 10.1371/journal.pone.0208391. eCollection 2018.
BACKGROUND
Paramedics are called on frequently to provide care to patients with mental health and/or and alcohol and other drug (AOD) problems, but may have mixed views about how this fits within their role.
AIMS
To explore paramedics' experience of caring for patients with non-medical emergency-related mental health and/or AOD problems, understand their perceptions of their scope of practice in caring for these patients, and ascertain if their practice should be extended to incorporate education with these patients.
METHOD
A convenience sample of 73 paramedics from most Australian states and territories-recruited through an online survey-participated in individual audio-recorded, qualitative interviews, conducted by telephone. The interviews were part of a mixed method study comprising qualitative interviews and online survey. A Framework Method of analysis to analyse the qualitative data.
RESULTS
Three themes and sub-themes were abstracted from the data about participants' experiences and, at times, opposing viewpoints about caring for patients with non-medical emergency-related mental health and/or AOD problems: caring for these patients is a routine part of paramedics' work, contrasting perspectives about scope of practice in caring for this group of patients, competing perspectives about extending scope of practice to incorporate education with this cohort of patients.
CONCLUSIONS
Paramedics need more undergraduate and in-service education about the care of patients with mental health and/or AOD problems, and to address concerns about extending their scope of practice to include education with these patients. Thought should be given to introducing alternative models of paramedic practice, such as community paramedicine, with a focus on supporting people in the community with mental health and/or AOD problems. There is a need for a change in workplace and organisational culture about scope of practice in caring for patients with these problems. Extending paramedics' role could, potentially, benefit people with these problems by improving the quality of care, reducing the need for transportation to emergency departments, and decreasing clinicians' workloads in these departments.
背景
急救人员经常被要求为心理健康和/或酒精和其他药物（AOD）问题的患者提供护理，但他们对这一角色的看法可能存在分歧。
目的
探讨急救人员照顾非医疗紧急相关心理健康和/或 AOD 问题患者的经验，了解他们对照顾这些患者的实践范围的看法，并确定是否应扩大他们的实践范围，纳入对这些患者的教育。
方法
通过在线调查从澳大利亚大多数州和地区招募了 73 名急救人员作为便利样本，参与了电话进行的个人音频记录的定性访谈。这些访谈是一项混合方法研究的一部分，包括定性访谈和在线调查。采用框架方法对定性数据进行分析。
结果
从数据中提取了三个主题和子主题，这些主题和子主题涉及参与者照顾非医疗紧急相关心理健康和/或 AOD 问题患者的经验，以及他们对照顾这组患者的实践范围的观点，有时甚至是对立的观点：照顾这些患者是急救人员工作的常规部分，对照顾这组患者的实践范围存在不同看法，对扩大实践范围以纳入对这组患者的教育存在不同看法。
结论
急救人员需要更多关于心理健康和/或 AOD 问题患者护理的本科和在职教育，并解决扩大其实践范围以包括对这些患者进行教育的担忧。应考虑引入替代的急救人员实践模式，例如社区急救医学，重点是支持社区中有心理健康和/或 AOD 问题的人。需要改变工作场所和组织文化，扩大照顾这些问题患者的实践范围。扩大急救人员的角色可以通过提高护理质量、减少对急诊科的转运需求以及减轻这些部门临床医生的工作量，潜在地使这些问题患者受益。
Zotero 插件