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住院患者 12 小时内未满足的社会需求:急性护理护士的定性研究。

"You only have time for so much in 12 hours" unmet social needs of hospitalised patients: A qualitative study of acute care nurses.

机构信息

Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.

Leonard Davis Institute of Health of Economics, Philadelphia, Pennsylvania.

出版信息

J Clin Nurs. 2019 Oct;28(19-20):3529-3537. doi: 10.1111/jocn.14944. Epub 2019 Jun 26.

Abstract

AIMS AND OBJECTIVES

To explore the experiences of nurses caring for socially at-risk patients and gain an understanding of the challenges nurses face when providing care.

BACKGROUND

Nurses play a pivotal role in caring for hospitalised patients with social risk factors and preparing them for discharge. Few studies have explored whether acute care nurses are adequately supported in their practice environments to address the unique needs of socially at-risk patients as they transition back into community settings.

DESIGN

A qualitative descriptive study of nurses working in a large urban academic medical centre.

METHODS

We conducted six semi-structured focus groups of nurses (n = 21). Thematic content analysis was performed to analyse the transcripts from the focus groups. We adhered to COREQ guidelines for reporting this qualitative study.

RESULTS

Six key themes emerged: (a) nurses' assessments of social risk factors, (b) experiences providing care, (c) barriers to care, (d) fear of "labelling" socially at-risk patients, (e) unmet social care needs and (f) recommendations to improve care.

CONCLUSIONS

Our findings suggest that nurses are able to identify social risk factors. However, prioritisation of medical needs during acute care hospitalisation and lack of organisational supports may deter nurses from fully addressing social concerns.

RELEVANCE TO CLINICAL PRACTICE

Acute care nurses should be involved in the development of future efforts to address the needs of socially at-risk patients and be provided with additional supports in their practice environments. This could include continuing education to build nursing competencies in community-based care and social vulnerability.

摘要

目的和目标

探索护理人员照顾社会风险患者的经验,并了解护理人员在提供护理时面临的挑战。

背景

护士在照顾有社会风险因素的住院患者并为其出院做准备方面发挥着关键作用。很少有研究探讨急性护理护士在实践环境中是否得到充分支持,以满足社会风险患者在返回社区环境时的独特需求。

设计

对在大型城市学术医疗中心工作的护士进行定性描述性研究。

方法

我们进行了六次护士半结构化焦点小组(n=21)。对焦点小组的记录进行了主题内容分析。我们遵循 COREQ 指南报告这项定性研究。

结果

出现了六个关键主题:(a)护士对社会风险因素的评估,(b)提供护理的经验,(c)护理障碍,(d)害怕“标记”社会风险患者,(e)未满足的社会护理需求,以及(f)改善护理的建议。

结论

我们的研究结果表明,护士能够识别社会风险因素。然而,在急性住院护理期间对医疗需求的重视以及缺乏组织支持可能会阻止护士全面解决社会问题。

临床实践相关性

急性护理护士应参与制定未来满足社会风险患者需求的努力,并在实践环境中为他们提供额外的支持。这可能包括继续教育,以建立护理人员在社区护理和社会脆弱性方面的能力。

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