Rantala Andreas, Nordh Sören, Dvorani Mergime, Forsberg Anna
Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden.
Emergency Department, Helsingborg General Hospital, SE-251 87 Helsingborg, Sweden.
Healthcare (Basel). 2021 Jan 12;9(1):66. doi: 10.3390/healthcare9010066.
The number of in-hospital beds in Sweden has decreased during recent decades, resulting in the smallest number (2.2 available beds/1000 inhabitants) within the European Union. At the same time, the number of patients attending Accident and Emergency (A&E) departments has increased, resulting in overcrowding and boarding. The aim of this study was to explore the meaning of being subjected to boarding at an A&E department, as experienced by patients. A phenomenological-hermeneutic approach was chosen to interpret and understand the meaning of boarding at A&E. The study was carried out at a hospital in the south of Sweden. Seventeen participants with a mean age of 64 years (range: 35-86 years) were interviewed. The thematic structural analysis covers seven themes: Being in a state of uncertainty, Feeling abandoned, Fearing death, Enduring, Adjusting to the circumstances, Being a visitor in an unsafe place, and Acknowledging the staff, all illustrating that the participants were in a state of constant uncertainty and felt abandoned with no guidance or support from the clinicians. The conclusion is that the situation where patients are forced to wait in A&E, i.e., boarding, violates all conditions for professional ethics, presumably causing profound ethical stress in the healthcare professionals involved. Thus, boarding should be avoided.
近几十年来，瑞典的医院床位数量有所减少，导致其成为欧盟范围内床位数量最少的国家（每1000名居民仅有2.2张可用床位）。与此同时，前往急诊部门就诊的患者数量却有所增加，导致了过度拥挤和住院延迟。本研究旨在探讨患者在急诊部门经历住院延迟的感受。我们采用现象学诠释学方法来解读和理解急诊住院延迟的意义。该研究在瑞典南部的一家医院进行。我们采访了17名平均年龄为64岁（年龄范围：35 - 86岁）的参与者。主题结构分析涵盖七个主题：处于不确定状态、感到被遗弃、恐惧死亡、忍耐、适应环境、在不安全的地方成为访客以及认可医护人员，所有这些都表明参与者处于持续的不确定状态，并且感觉被遗弃，没有得到临床医生的指导或支持。结论是，患者被迫在急诊室等待的情况，即住院延迟，违反了职业道德的所有条件，可能会给相关医护人员带来深刻的道德压力。因此，应避免住院延迟。
