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危重症患者在重症监护病房的护理体验。

Critically ill patients' experiences of nursing care in the intensive care unit.

机构信息

Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Nurs Crit Care. 2019 Nov;24(6):392-398. doi: 10.1111/nicc.12409. Epub 2019 Jan 30.

Abstract

BACKGROUND

Understanding critically ill patients' experiences of nursing care is an important aspect that can improve quality of care in the intensive care unit.

AIM

To elicit critically ill patients' experiences of nursing care in the adult intensive care units.

DESIGN

A qualitative descriptive design was utilized.

METHODS

Sixteen patients who had a predicted mortality risk of above 50% within the first 24 h of admission to the intensive care unit and had been discharged to the ward were purposively selected. The study was conducted at three academic affiliated, tertiary/quaternary specialist hospitals in South Africa. Individual semi-structured interviews were conducted with the selected participants until a point of data saturation was reached. Data were analysed using a conventional content analysis technique (Hsieh and Shannon, 2005). Lincoln and Guba's criteria for ensuring the trustworthiness of qualitative research were applied.

FINDINGS

Four major themes emerged: 'being in someone's shoes', 'communication', 'presence' and 'religion and spirituality'.

CONCLUSIONS

Even though some participants' responses reflected 'good' nursing care, the majority of the participants had negative experiences in relation to the nursing care they received while admitted in the selected intensive care units.

RELEVANCE TO CLINICAL PRACTICE

This study demonstrates critically ill patients' voices and preferences of intensive nursing care and describes some issues that require not only nurses' but also managerial improvements and interventions in order to ensure quality care and, eventually, patients' satisfaction with intensive nursing care.

摘要

背景

了解重症患者的护理体验是提高重症监护病房护理质量的一个重要方面。

目的

引出重症监护病房成人患者的护理体验。

设计

采用定性描述设计。

方法

从南非三所学术附属的三级/四级专科医院中,选择了 16 名预计在入住重症监护病房的前 24 小时内死亡率超过 50%且已转至病房的患者进行有针对性的选择。对选定的参与者进行了个体半结构化访谈,直到达到数据饱和点。使用传统的内容分析技术(Hsieh 和 Shannon,2005)对数据进行分析。应用林肯和古巴的定性研究可信度标准。

结果

出现了四个主要主题:“换位思考”、“沟通”、“存在”和“宗教和精神”。

结论

尽管一些参与者的反应反映了“良好”的护理,但大多数参与者对他们在选定的重症监护病房接受的护理有负面体验。

临床意义

这项研究展示了重症患者对重症护理的意见和偏好,并描述了一些不仅需要护士,还需要管理改进和干预的问题,以确保提供优质护理,并最终使患者对重症护理满意。

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