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护士对长期护理机构中老年人提供心理关怀的看法:一项定性研究。

Nurses' perceptions regarding providing psychological care for older residents in long-term care facilities: A qualitative study.

机构信息

Department of Allied Health Education & Digital Learning, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.

Discipline of Nursing, School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia.

出版信息

Int J Older People Nurs. 2019 Sep;14(3):e12242. doi: 10.1111/opn.12242. Epub 2019 May 9.

Abstract

AIMS AND OBJECTIVES

To explore nurses' perceptions regarding providing psychological health care for older residents in long-term care facilities (LTCFs).

BACKGROUND

Loneliness and depressive symptoms are commonly observed among older residents living in LTCFs. Nurses are expected to provide holistic care including physical, psychological and social care for older residents in LTCFs to fulfil their needs. Therefore, understanding nurses' feelings and thoughts regarding providing care for older residents who feel lonely, sad, unhappy or depressed is important for delivering better care.

DESIGN

A qualitative research design was employed. The Standards for Reporting Qualitative Research (SRQR) was used to enhance for reporting quality.

METHODS

Purposive sampling and snowball sampling were applied in Northern Taiwan. One-to-one in-depth interviews were conducted using a semi-structured interview guide. Twenty-one nurses with a mean age of 38.4 years were interviewed. Content analysis was performed for data analysis.

FINDINGS

Four themes were generated from the data: "insufficient psychological healthcare competency," "having a willing heart but not adequate support," "families playing an essential role in residents' mood" and "physical-oriented care model."

CONCLUSIONS

Long-term care facilitie nurses felt that they were not adequately prepared for taking care of older adults' psychological problems before their nursing career or during their practice. Unreasonable nurse-to-resident ratios and an absence of care consensus among healthcare providers can make nurses feel that they have a willing heart but not adequate support. Family members are essential in older residents' emotional status within the Taiwanese cultural context. Physical care evaluation indicators emphasised by LTCF accreditation resulted in the current care practice model.

IMPLICATIONS FOR PRACTICE

This study provides valuable information for LTCF nurses, managers and directors to develop appropriate strategies to assist nurses in providing better psychological health care for older residents. Evaluation indicators required by LTCF accreditation in Taiwan must be re-examined at the earliest stage.

摘要

目的和目标

探索护士对长期护理机构(LTCF)中老年人提供心理健康护理的看法。

背景

孤独和抑郁症状在居住在 LTCF 的老年人中很常见。护士预计将为 LTCF 中的老年人提供全面的护理,包括身体、心理和社会护理,以满足他们的需求。因此,了解护士对孤独、悲伤、不快乐或沮丧的老年人提供护理的感受和想法,对于提供更好的护理非常重要。

设计

采用定性研究设计。采用标准报告定性研究(SRQR)来提高报告质量。

方法

在台湾北部采用了目的抽样和滚雪球抽样。使用半结构化访谈指南进行一对一的深入访谈。共采访了 21 名平均年龄为 38.4 岁的护士。进行了内容分析以进行数据分析。

结果

从数据中产生了四个主题:“心理保健能力不足”、“有心无力”、“家庭在居民情绪中起着重要作用”和“以身体为中心的护理模式”。

结论

长期护理机构的护士们觉得他们在护理生涯之前或实践期间都没有为照顾老年人的心理问题做好充分的准备。不合理的护士与居民比例以及医疗保健提供者之间缺乏护理共识,会让护士感到有心无力。在台湾的文化背景下,家庭成员对老年人的情绪状态至关重要。LTCF 认证强调的身体护理评估指标导致了当前的护理实践模式。

实践意义

本研究为长期护理机构的护士、管理人员和董事提供了有价值的信息,以制定适当的策略,帮助护士为老年人提供更好的心理健康护理。台湾 LTCF 认证所需的评估指标必须尽快重新审查。

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