Yazdimoghaddam Hamideh, Manzari Zahra Sadat, Heydari Abbas, Mohammadi Eesa
Assistant Professor, Non-Communicable Diseases Research Center, Operating Room Department, Faculty of Paramedics, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Associate Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
J Med Ethics Hist Med. 2021 Feb 15;14:2. doi: 10.18502/jmehm.v14i2.5435. eCollection 2021.
Nurses are faced with tremendous pressure when providing brain-dead patients with care. There is limited guidance for nurses on the care of these patients. The present study aimed to report the experiences of nurses regarding the care of patients diagnosed with brain death. Semi-structured interviews were conducted with 31 nurses and other stakeholders, and the observations and field notes were analyzed using continuous and comparative analysis based on grounded theory. The qualitative analysis of the data resulted in extraction of six final categories, including 'facing increased tensions and conflicts', 'organ donation: a distinct care element', 'inconsistency of care management', 'effective care requirements', 'challenges, rights and duty requirements', and 'moral obligation to provide holistic care until the last minute'. Data analysis identified 'Challenges, rights and duty requirements' as the main issue and showed that the nurses managed this issue using the strategy of 'moral obligation to provide holistic care until the last minute' as the core variable. According to the results, it is recommended that the healthcare system (especially hospital management) take supportive action for nurses in various fields of care of brain-dead patients to resolve educational, moral and legal challenges.
护士在为脑死亡患者提供护理时面临着巨大压力。对于护士护理这些患者的指导有限。本研究旨在报告护士在护理被诊断为脑死亡患者方面的经历。对31名护士和其他利益相关者进行了半结构化访谈，并基于扎根理论使用持续比较分析对观察结果和实地记录进行了分析。对数据的定性分析得出了六个最终类别，包括“面临更多紧张和冲突”、“器官捐献：一个独特的护理要素”、“护理管理的不一致”、“有效的护理要求”、“挑战、权利和义务要求”以及“直到最后一刻提供整体护理的道德义务”。数据分析确定“挑战、权利和义务要求”为主要问题，并表明护士以“直到最后一刻提供整体护理的道德义务”这一策略作为核心变量来应对该问题。根据研究结果，建议医疗保健系统（尤其是医院管理层）在脑死亡患者护理的各个领域为护士采取支持行动，以解决教育、道德和法律方面的挑战。
