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护士在急症医院护理有反应性行为的痴呆症患者的经历:一项质性描述性研究。

Nurses' experiences of caring for persons with dementia experiencing responsive behaviours in an acute hospital: A qualitative descriptive study.

作者信息

Dookhy Joshi, Daly Louise

机构信息

Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland.

School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland.

出版信息

Int J Older People Nurs. 2021 Jul;16(4):e12379. doi: 10.1111/opn.12379. Epub 2021 May 7.

Abstract

OBJECTIVE

To explore nurses' experiences of caring for persons with dementia experiencing responsive behaviours in an acute hospital.

BACKGROUND

Caring for persons with dementia who have an acute medical illness and are experiencing responsive behaviours in acute hospitals can be challenging for nurses. While existing research has explored the experiences of nurses in providing dementia care in this setting, there is limited knowledge about the specific care experiences of nurses when working to meet the needs of persons with dementia who experience responsive behaviours alongside an admitting diagnosis.

METHOD

A qualitative descriptive design was implemented. Semi-structured interviews were carried out with nine nurses working in medical and surgical wards. A thematic analysis approach was used to analyse the data. Ethical approval to conduct the study was received from the writers' university.

RESULTS

Three themes were found: (a) challenges encountered, (b) a person-centred response and (c) dementia preparedness. Key findings about challenges encountered by nurses included: the acute hospital environment; increased need for enhanced knowledge; and emotional challenges. Person-centred responses such as working in partnership with others and reminiscence were identified as strategies to address the challenges. Finally, nurses identified particular interventions that were supportive to them in enhancing their preparedness to meet the needs of persons with dementia who experience responsive behaviours.

CONCLUSIONS

Persons with dementia who are acutely unwell and are experiencing responsive behaviours, within acute hospitals, have specific and individualised care needs. Nurses working in these settings must therefore be supported in developing competence in managing these frequently complex clinical cases, while also providing person-centred care.

IMPLICATION FOR PRACTICE

Nurses' narratives demonstrate that they continue to experience challenges in the presence of responsive behaviours. There is a consequent need for dementia-specific education on person-centred ways to address responsive behaviours within acute hospital settings.

摘要

目的

探讨护士在急症医院护理有反应性行为的痴呆患者的经历。

背景

在急症医院护理患有急性疾病且有反应性行为的痴呆患者对护士来说可能具有挑战性。虽然现有研究探讨了护士在这种环境下提供痴呆护理的经历,但对于护士在努力满足患有反应性行为且伴有入院诊断的痴呆患者需求时的具体护理经历,了解有限。

方法

采用定性描述性设计。对在内科和外科病房工作的9名护士进行了半结构式访谈。采用主题分析法对数据进行分析。该研究获得了作者所在大学的伦理批准。

结果

发现了三个主题:(a)遇到的挑战,(b)以患者为中心的应对方式,以及(c)痴呆症准备情况。护士遇到的挑战的主要发现包括:急症医院环境;对增强知识的需求增加;以及情感挑战。与他人合作和怀旧等以患者为中心的应对方式被确定为应对挑战的策略。最后,护士们确定了一些特别的干预措施,这些措施有助于他们提高应对有反应性行为的痴呆患者需求的准备能力。

结论

在急症医院中,患有急性疾病且有反应性行为的痴呆患者有特定的个性化护理需求。因此,必须支持在这些环境中工作的护士培养管理这些频繁出现的复杂临床病例的能力,同时提供以患者为中心的护理。

对实践的启示

护士的叙述表明,在出现反应性行为时,他们仍然面临挑战。因此,需要针对痴呆症进行专门教育,以传授在急症医院环境中以患者为中心的方式应对反应性行为。

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