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探索在急诊科经历流产的父母的需求:一项针对父母和护士的定性研究。

Exploring the needs of parents who experience miscarriage in the emergency department: A qualitative study with parents and nurses.

作者信息

Emond Tina, de Montigny Francine, Guillaumie Laurence

机构信息

Faculty of Nursing, Université Laval, Quebec City, Quebec.

Faculty of Nursing, University du Québec en Outaouais, Gatineau, Quebec.

出版信息

J Clin Nurs. 2019 May;28(9-10):1952-1965. doi: 10.1111/jocn.14780. Epub 2019 Feb 18.

Abstract

AIMS AND OBJECTIVES

To understand how parents experienced miscarriage in an emergency department setting. Objectives were to identify parents' needs, isolate factors that influenced their experience, and provide recommendations to improve care from the perspective of women, their partners, nurses and nurse managers.

BACKGROUND

Miscarriage is the most prevalent complication encountered during pregnancy. It subjects parents to a multitude of emotions and may have significant consequences on mental health. Emergency department visits are frequently the only opportunity for parents to receive formal support during a miscarriage; it is thus crucial to understand the experiences of parents in this setting.

DESIGN

The study employed a descriptive, exploratory, qualitative approach with semi-structured interviews.

METHODS

The study was founded on the W.K. Kellogg Foundation's Logic Model Development Guide (2004) and Meleis' Transitions Theory (2015). A total of 26 participants were interviewed (17 parents, 7 emergency department nurses and 2 emergency department nurse managers). Consolidated criteria for reporting qualitative research was used to report results.

RESULTS

Three categories of needs were identified: physical health, cognitive and emotional. For instance, parents expressed a need to receive more information during their visit to the emergency department (i.e., a cognitive need), whether about the diagnostic test results or how to ensure a better recovery. Parents also reported a desire for professionals to address their emotional concerns. Nurses were aware of the emotional impact of miscarriage but felt that they were not adequately trained in providing optimal care to parents in this situation.

CONCLUSIONS

Parents who visited the emergency department for miscarriage reported several unfulfilled needs that generated dissatisfaction with care. Emergency department organisational constraints hindered optimal nursing care practices.

RELEVANCE TO CLINICAL PRACTICE

Nurses have an important role to play in improving parents' experience. They can do so by understanding the needs of parents and by being involved in developing new guidelines.

摘要

目的与目标

了解父母在急诊科环境中经历流产的情况。目标是确定父母的需求,找出影响他们经历的因素,并从女性、其伴侣、护士和护士长的角度提供改善护理的建议。

背景

流产是孕期最常见的并发症。它使父母经历多种情绪,可能对心理健康产生重大影响。急诊科就诊往往是父母在流产期间获得正式支持的唯一机会;因此,了解父母在这种情况下的经历至关重要。

设计

本研究采用描述性、探索性、定性研究方法,进行半结构化访谈。

方法

本研究基于W.K. 凯洛格基金会的逻辑模型开发指南(2004年)和梅莱伊斯的过渡理论(2015年)。共采访了26名参与者(17名父母、7名急诊科护士和2名急诊科护士长)。采用定性研究报告的统一标准来报告结果。

结果

确定了三类需求:身体健康、认知和情感需求。例如,父母表示在急诊科就诊期间需要获得更多信息(即认知需求),无论是关于诊断测试结果还是如何确保更好的康复。父母还表示希望专业人员解决他们的情感问题。护士意识到流产的情感影响,但觉得自己在这种情况下为父母提供最佳护理方面没有得到充分培训。

结论

因流产前往急诊科就诊的父母报告了一些未得到满足的需求,这些需求导致他们对护理不满意。急诊科的组织限制阻碍了最佳护理实践。

与临床实践的相关性

护士在改善父母的就医体验方面可发挥重要作用。他们可以通过了解父母的需求并参与制定新指南来做到这一点。

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