Sundberg Fredrika, Fridh Isabell, Olausson Sepideh, Lindahl Berit
Department of Caring Science, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden (Ms Sundberg and Drs Fridh and Lindahl); Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden (Dr Fridh); and Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Dr Olausson).
Crit Care Nurs Q. 2019 Jul/Sep;42(3):265-277. doi: 10.1097/CNQ.0000000000000267.
Medical technology has progressed tremendously over the last few decades, but the same development cannot be seen in the design of these intensive care unit environments. Authors report results of a study of evidence-based room design, emphasizing the impact on conveying a caring attitude to patients. Ten nonparticipant observations were conducted in patient rooms with 2 different designs, followed by interviews. The data were analyzed using a phenomenological-hermeneutical approach. The results did not reveal that it was obvious that redesigned spaces resulted in a more caring attitude. The meanings of caring displayed during nursing activities were interpreted by interpreting gazes. Some of the nursing staff had an instrumental gaze, interpreted as caring with a task-orientated approach, while others communicated their caring with an attentive and attuned gaze, where the needs of the patients regulated the working shift. The study findings indicated that caring may not be perceived when nurses use a task-oriented approach. However, when nurses practice a person-centered approach, using an attentive and attuned gaze, caring is conveyed. Caring in intensive care contexts needs to be assisted by a supportive environment design that cultivates the caring approach.
在过去几十年里，医疗技术取得了巨大进步，但重症监护病房环境的设计却没有同样的发展。作者报告了一项基于证据的病房设计研究结果，强调了其对向患者传达关怀态度的影响。在两种不同设计的病房中进行了10次非参与性观察，随后进行了访谈。采用现象学-诠释学方法对数据进行分析。结果并未表明重新设计的空间明显带来了更关怀的态度。护理活动中所展现的关怀含义通过解读目光来阐释。一些护理人员有工具性目光，被解读为以任务为导向的关怀方式，而另一些人则通过专注且协调的目光传达关怀，患者的需求调节着工作班次。研究结果表明，当护士采用以任务为导向的方法时，可能无法被察觉到关怀。然而，当护士采用以人为本的方法，用专注且协调的目光时，关怀就能得以传达。重症监护环境中的关怀需要一个培养关怀方式的支持性环境设计来辅助。
