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护士照顾谵妄患者的经验:系统评价与定性证据综合

Nurses' Experience of Caring for Patients with Delirium: Systematic Review and Qualitative Evidence Synthesis.

作者信息

Thomas Nissy, Coleman Mardhie, Terry Daniel

机构信息

School of Health, Federation University Australia, Ballarat 3350, Australia.

出版信息

Nurs Rep. 2021 Mar 5;11(1):164-174. doi: 10.3390/nursrep11010016.

Abstract

Delirium is an acute deterioration in attention, conscious state, perception, and cognition of a person. While nurses possess the theoretical understanding of the condition, they lack insight into its early recognition and management. This systematic review aims to understand what factors influence nurses as they care for patients with delirium, and to identify best practices to improve overall clinical care. The Qualitative Evidence Synthesis (QES), as a strategy process to identify gaps in research, formulate new models or strategies for care, underpinned the review. In addition to specific inclusion and exclusion criteria, a methodological assessment, data were analysed using QES, as informed by the Joanna Briggs Institute Review process. Ten studies were identified and synthesised to generate four key themes. The themes included (1) nurse's knowledge deficit; (2) increased workload and stress; (3) safety concerns among nurse when caring for patients with delirium; and (4) strategies used when caring for patients with delirium. Overall, the review has highlighted the need for increased delirium education and coping strategies among nurses to effectively care for patients with delirium. This may be augmented through regular education sessions to provide nurses with the confidence and competence to care for the acutely confused person.

摘要

谵妄是指一个人的注意力、意识状态、感知和认知能力出现急性衰退。虽然护士对这种病症有理论上的了解,但他们缺乏对其早期识别和管理的洞察力。本系统评价旨在了解哪些因素会影响护士护理谵妄患者,并确定改善整体临床护理的最佳实践方法。定性证据综合法(QES)作为一种识别研究空白、制定新的护理模式或策略的策略性过程,为该评价提供了支撑。除了特定的纳入和排除标准、方法学评估外,还按照乔安娜·布里格斯循证护理中心循证过程对数据进行了QES分析。共确定并综合了10项研究,得出4个关键主题。这些主题包括:(1)护士的知识欠缺;(2)工作量和压力增加;(3)护士在护理谵妄患者时的安全担忧;(4)护理谵妄患者时所采用的策略。总体而言,该评价强调有必要加强护士的谵妄知识教育和应对策略,以便有效地护理谵妄患者。这可以通过定期开展教育课程来加强,从而让护士有信心和能力护理急性意识模糊的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5667/8608072/74a1504f14be/nursrep-11-00016-g001.jpg

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