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患者的议程:护士学习和使用引导自主决策的经验。

The patient's agenda: nurses' experience of learning and using guided self-determination.

机构信息

Juliane Marie Centre, Department of Gynaecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Juliane Marie Centre, Department of Gynaecology and Women's and Children's Health Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

出版信息

Scand J Caring Sci. 2022 Mar;36(1):120-130. doi: 10.1111/scs.12969. Epub 2021 Feb 11.

Abstract

OBJECTIVES

Health care has seen a shift towards person-centred care to encompass the entirety of a person's needs and preferences, but research is sparse on healthcare professionals learning and using person-centred care.

AIM

To investigate nurses' experiences of learning and using the person-centred method guided self-determination (GSD) in three different gynaecological settings and to determine whether, and potentially, how new tasks introduced by the GSD method influence their professional identity.

DESIGN

A qualitative interview study conducted between January 2019 and January 2020.

METHOD

We conducted 16 semi-structured interviews with nurses educated in using GSD. Applying inductive and deductive reasoning, we analysed the interviews using thematic analysis. The study was registered with the Danish Data Protection Agency (file no.: VD-2018-445, I-Suite no.: 6700).

RESULTS

The analysis generated three main themes with two subthemes each: (a) prerequisites and barriers to learning and using GSD in terms of personal factors and organisational and method-related factors; (b) new knowledge and understanding of illness with the subthemes expanded understanding of illness and a different relationship; and (c) nursing undergoing change with the subthemes, a new role and a professional self shaped through interaction with other professions.

CONCLUSIONS

Although other professionals may have either supported or challenged the use of GSD, most nurses indicated that it supplemented their professional role and identity as they gained new knowledge about person-centred challenges and felt more confident. When introducing GSD in nursing, the organisation must not only consider individual characteristics, multidisciplinary collaboration and communication but also plan individual education and supervision. This is necessary because all these factors affect how a new professional role is constructed and adopted, not to mention how it influences the nurses' perception of their professional identity and use of GSD. Establishing a helpful person-centred environment must also be considered.

摘要

目的

医疗保健已经向以患者为中心的护理转变,以涵盖患者的全部需求和偏好,但关于医疗保健专业人员学习和使用以患者为中心的护理的研究很少。

目的

调查护士在三种不同妇科环境中学习和使用以患者为中心的方法指导自主决策(GSD)的经验,以及确定 GSD 方法引入的新任务是否以及可能如何影响他们的专业身份。

设计

2019 年 1 月至 2020 年 1 月期间进行的定性访谈研究。

方法

我们对接受过 GSD 培训的护士进行了 16 次半结构化访谈。应用归纳和演绎推理,我们使用主题分析对访谈进行了分析。该研究已在丹麦数据保护局注册(文件号:VD-2018-445,I-Suite 号:6700)。

结果

分析产生了三个主要主题,每个主题都有两个子主题:(a)学习和使用 GSD 的个人因素、组织因素和方法因素方面的前提条件和障碍;(b)对疾病的新知识和理解,包括扩展的疾病理解和不同的关系;(c)护理正在发生变化,包括新角色和通过与其他专业人员的互动形成的专业自我。

结论

尽管其他专业人员可能支持或挑战 GSD 的使用,但大多数护士表示,它补充了他们的专业角色和身份,因为他们获得了关于以患者为中心的挑战的新知识,并感到更有信心。在护理中引入 GSD 时,组织不仅必须考虑个人特征、多学科合作和沟通,还必须计划个人教育和监督。这是必要的,因为所有这些因素都会影响新的专业角色的构建和采用,更不用说影响护士对自己专业身份的看法以及他们对 GSD 的使用了。还必须考虑建立一个有益的以患者为中心的环境。

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