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一项关于埃塞俄比亚亚的斯亚贝巴 ICU 患者家属生活体验的现象学研究。

A phenomenological study on the lived experiences of families of ICU patients, Addis Ababa, Ethiopia.

机构信息

St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.

出版信息

PLoS One. 2020 Dec 18;15(12):e0244073. doi: 10.1371/journal.pone.0244073. eCollection 2020.

Abstract

BACKGROUND

Family-centered care of ICU patients is increasingly recommended as it is believed to have effect on family members' psychosocial status and patient outcomes. Defining the nature and extent of families' involvement in a given health care environment for different stakeholders is a challenge. Understanding the lived experiences of families of ICU patients would help strategize on how to better engage family members for improved ICU care processes and outcomes.

OBJECTIVES

The aim of this study is to explore the lived experiences of families of patients in the ICUs of hospitals in Addis Ababa, Ethiopia.

METHODS

The study adopted a qualitative approach and a phenomenological research design. In-depth interviews were conducted with twelve (12) family members who were purposively sampled from two government hospitals and four private hospitals. Thematic approach with the application of hermeneutic circle of interpretation was applied to understand the meanings of their experiences.

RESULTS

The study revealed the following major themes: financial burden, challenge in decision making, shattered family integrity and expectations, information and communication gap between family members and health professionals, lack of confidence in the service delivery of hospitals, social pressure against patient families, and families being immersed in an unfriendly environment. Though they do not explicitly mention it to the health care tram, further interpretation of the main themes elucidated that family's need the intensive care process be cut shorter irrespective of the outcome of the patient condition.

CONCLUSION

The study gave an insight on the multiple and interrelated challenges faced by families of ICU patients admitted in the hospitals of Addis Ababa. Further contextualized interpretation of their experiences revealed that families were somehow in a state of despair and they implicitly need the ICU care for their family member be ended irrespective of the potential clinical consequences on the patient. The philosophy of family-centered care be advocated in hospitals. The study result affirms the need to include family members during nursing assessment of patients in ICUs and also offers the basis for guidelines development on informational support to the families of the patients hospitalized in ICUs.

摘要

背景

以家庭为中心的 ICU 患者护理越来越受到推崇,因为人们相信这对家庭成员的心理社会状况和患者预后有影响。为不同利益相关者定义家庭在特定医疗保健环境中参与的性质和程度是一项挑战。了解 ICU 患者家属的生活体验有助于制定战略,更好地让家庭成员参与进来,以改善 ICU 护理流程和结果。

目的

本研究旨在探讨埃塞俄比亚亚的斯亚贝巴医院 ICU 患者家属的生活体验。

方法

该研究采用定性方法和现象学研究设计。通过深入访谈,从两家政府医院和四家私人医院有目的地抽取了 12 名(12)名家属。应用解释学解释的解释学循环的主题方法来理解他们的经验的意义。

结果

研究揭示了以下主要主题:经济负担、决策挑战、家庭完整性和期望破灭、家庭成员与卫生专业人员之间的信息和沟通差距、对医院服务提供缺乏信心、社会对患者家庭的压力、以及家庭沉浸在一个不友好的环境中。尽管他们没有向医疗团队明确提及,但对主要主题的进一步解释阐明了家庭希望缩短重症监护过程,而不管患者病情的结果如何。

结论

该研究深入了解了亚的斯亚贝巴医院 ICU 患者家属面临的多种相互关联的挑战。对他们的经历进行进一步的背景解释表明,家庭在某种程度上处于绝望状态,他们隐含地希望他们的家庭成员的 ICU 护理结束,而不管对患者潜在的临床后果如何。应倡导医院以家庭为中心的护理理念。该研究结果肯定了在 ICU 中对患者进行护理评估时需要包括家庭成员,并为制定关于向 ICU 住院患者家属提供信息支持的指南提供了依据。

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