Øfsti Ruth, Devik Siri Andreassen, Enmarker Ingela, Olsen Rose Mari
Nord University, Levanger, Norway.
Nord University, Namsos, Norway.
Glob Qual Nurs Res. 2020 Aug 17;7:2333393620946331. doi: 10.1177/2333393620946331. eCollection 2020 Jan-Dec.
Nurses working in home care play a significant role in observing and identifying changes in the health status of patient with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore and describe nurses' observations of older patients with COPD when providing home nursing care. In this qualitative explorative study, data were collected through observations of 17 home care visits using the think-aloud technique, followed up with individual interviews with the nurses. Qualitative content analysis was used to analyze the data. The findings showed that the nurses' observations (focus, methods, and interpretation) were characterized by their search for deviations from what they judged to be the patient's habitual state. The nurses did not use any tool or guidelines, nor did they follow a standard procedure. Instead, when observing and interpreting, they performed a complex process guided by their experience and knowledge of the patient, and the patient's individual and contextual circumstances. This knowledge contributes to warranted reflection on nurses' practice in this context to secure COPD patients' safety and quality of life.
从事家庭护理工作的护士在观察和识别慢性阻塞性肺疾病（COPD）患者的健康状况变化方面发挥着重要作用。本研究的目的是探讨和描述护士在提供家庭护理时对老年COPD患者的观察情况。在这项定性探索性研究中，通过采用出声思考技术对17次家庭护理访视进行观察来收集数据，随后对护士进行个别访谈。采用定性内容分析法对数据进行分析。研究结果表明，护士的观察（重点、方法和解读）的特点是寻找与他们所认为的患者习惯状态的偏差。护士没有使用任何工具或指南，也没有遵循标准程序。相反，在观察和解读时，他们进行了一个由其对患者的经验和知识以及患者的个体和背景情况所指导的复杂过程。这些知识有助于在此背景下对护士的实践进行有根据的反思，以确保COPD患者的安全和生活质量。
