Jang Myoung Sun, Kim Sungjae
College of Nursing, Seoul National University, Seoul, Korea.
College of Nursing·The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
J Korean Acad Nurs. 2019 Aug;49(4):423-436. doi: 10.4040/jkan.2019.49.4.423.
The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care.
Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data.
Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory.
The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.
本研究旨在探讨重症监护环境下护士以患者为中心的关系性护理体验。
基于特拉维比提出的人际关系模型制定关键访谈问题。通过对11名在重症监护病房有超过2年工作经验的护士进行目的抽样深入访谈收集数据。采用解释现象学分析方法对数据进行分析。
确定了4个上位主题和9个下位主题。出现的上位主题如下:(1)通过患者监测系统接触真实的人;(2)深度共情连接;(3)人文关怀和同情护理;(4)陪伴患者走到生命尽头。研究结果显示,重症监护病房的护士在与临终患者建立人际关系时,在护理过程中体验到了“情绪平衡”和“真实性”。发现重症监护病房以患者为中心的关系性护理现象包含了共情、同情和信任的内在属性,类似于特拉维比理论的核心概念。
本研究的解释性结果为深入理解特拉维比的人际关系模型提供了依据。重症监护病房的技术环境并未阻碍经验丰富的护士建立人际关系。这些主题在重症护理教育以及护理管理中都需要得到强调。本研究结果将有助于深入理解护患关怀关系,并有助于提高重症监护病房的护理质量。