重症监护病房为老年患者提供护理的挑战与障碍：一项定性研究
Challenges and Barriers to Providing Care to Older Adult Patients in the Intensive Care Unit: A Qualitative Research.
作者信息
Heydari Abbas, Sharifi Mohammadhesam, Moghaddam Ahmad Bagheri
机构信息
Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
出版信息
Open Access Maced J Med Sci. 2019 Oct 13;7(21):3682-3690. doi: 10.3889/oamjms.2019.846. eCollection 2019 Nov 15.
BACKGROUND
Enhancing the quality of care for elderly patients needs an understanding of the challenges and obstacles experienced by the intensive care unit (ICU) staff in providing care.
AIM
To explore the most challenging issues experienced by ICU staff, in particular, nurses, in the care of elderly patients in the general adult ICU.
DESIGN
A qualitative research design was employed. The Standards for Reporting Qualitative Research (SRQR) were followed.
METHODS
Based on theoretical sampling, we carried out 34 in-depth semi-structured interviews from two medical adult ICUs. Data analysis was carried out using qualitative conventional content analysis.
RESULTS
Data analysis led to the identification of three interrelated categories and 12 subcategories. Three main categories were factors related to nurses' attitude in elderly care, factors related to the system of care, and factors related to the models of patient care delivery. These categories came under the main theme of "Inappropriate and unfair system for elderly care".
CONCLUSION
The findings of this study increase scholarly understanding of challenges and barriers to providing care to elderly patients in the general adult ICU. We found that the provision of care to elderly patients is inappropriate and unfair. Various obstacles must be overcome to improve the care of these patients. For example, negative attitudes toward elder care, inappropriate environments, lack of resources, lack of knowledge and skills, a specialized model of care delivery, respect for humanity, care without considering patient age, and separating professional conflicts from patient care. These findings may be used by ICU's caregivers and managers to improve the quality of care.
IMPLICATIONS FOR PRACTICE
Various obstacles were documented that need to be overcome by hospital administrators, nursing managers, clinical nurses, nursing educators, nursing researchers to improve the care of elderly patients admitted to ICU.
背景
提高老年患者的护理质量需要了解重症监护病房（ICU）工作人员在提供护理时所面临的挑战和障碍。
目的
探讨ICU工作人员，尤其是护士，在成人综合ICU护理老年患者时所面临的最具挑战性的问题。
设计
采用定性研究设计。遵循定性研究报告标准（SRQR）。
方法
基于理论抽样，我们对两个成人医疗ICU进行了34次深入的半结构化访谈。使用定性常规内容分析法进行数据分析。
结果
数据分析确定了三个相互关联的类别和12个子类别。三个主要类别是与护士老年护理态度相关的因素、与护理系统相关的因素以及与患者护理模式相关的因素。这些类别归属于“不适当和不公平的老年护理系统”这一主题。
结论
本研究结果增进了学术界对成人综合ICU中为老年患者提供护理的挑战和障碍的理解。我们发现为老年患者提供的护理是不适当和不公平的。必须克服各种障碍以改善对这些患者的护理。例如，对老年护理的消极态度、不适当的环境、资源匮乏、知识和技能不足、专门的护理模式、尊重人性、不考虑患者年龄的护理以及将职业冲突与患者护理分开。这些发现可供ICU护理人员和管理人员用于提高护理质量。
对实践的启示
记录了各种需要医院管理人员、护理管理人员、临床护士、护理教育工作者、护理研究人员克服的障碍，以改善入住ICU的老年患者的护理。
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