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患者尊严和有尊严的护理:住院老年人观点的定性描述。

Patient dignity and dignified care: A qualitative description of hospitalised older adults perspectives.

机构信息

School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.

Monash Nursing and Midwifery, Monash University, Melbourne, Vic., Australia.

出版信息

J Clin Nurs. 2023 Apr;32(7-8):1286-1302. doi: 10.1111/jocn.16286. Epub 2022 Mar 23.

Abstract

AIMS AND OBJECTIVES

The aim of this study was to explore older adults' perspectives about dignity and dignified nursing care during acute hospitalisation in Ghana.

BACKGROUND

Maintaining hospitalised older adults' dignity is an essential component of nursing care and one of the most important determinants of wellbeing. To date, no study has been published on older adults' perspectives of dignified nursing care in the African context.

STUDY DESIGN

A qualitative descriptive research design.

METHODS

Twenty hospitalised older adults were purposively selected from the medical and surgical wards of a teaching hospital in Ghana. Data were gathered through semi-structured interviews between April and August, 2021, and analysed using reflexive thematic analysis techniques. The SRQR checklist was used to document reporting of the study.

RESULTS

The following four themes were identified: Effective nurse-patient communication, Maintaining patients' privacy, Respectful and compassionate care provision and Providing quality and safe care. Dignity was preserved when patients were treated with respect and compassion, provided privacy, and had close family members involved in physical care. Identified barriers to dignity included inadequate information about their health condition, poor communication by the nurses, lack of autonomy, poorly designed healthcare infrastructure and inadequate privacy.

CONCLUSIONS

Several enablers and barriers to dignified nursing care have been identified that have been discussed in previous studies. The unique factors identified in the Ghanaian context were family members' involvement in physical care influenced by cultural and religious beliefs, environmental barriers to privacy and dignity and inadequate involvement in decision making.

RELEVANCE TO CLINICAL PRACTICE

Nurses must treat older patients with respect, educate them about the health condition, involve them in care decisions, and identify their preferences regarding provision of hygiene needs, particularly in consideration of religious and cultural beliefs, including involvement of family members. Future planning of healthcare infrastructure needs to consider the importance of private cubicles with disability-accessible ensuite bathrooms for patients' comfort and privacy.

摘要

目的和目标

本研究旨在探讨加纳急性住院老年患者对尊严和尊严护理的看法。

背景

维护住院老年患者的尊严是护理的重要组成部分,也是幸福感的最重要决定因素之一。迄今为止,在非洲背景下,尚无关于老年患者对尊严护理看法的研究。

研究设计

定性描述性研究设计。

方法

从加纳一所教学医院的内科和外科病房中,有目的地选择了 20 名住院老年患者。数据于 2021 年 4 月至 8 月通过半结构化访谈收集,并使用反思性主题分析技术进行分析。使用 SRQR 清单记录研究报告。

结果

确定了以下四个主题:有效的护患沟通、维护患者隐私、提供尊重和富有同情心的护理以及提供优质和安全的护理。当患者受到尊重和同情、提供隐私以及有亲密的家庭成员参与身体护理时,尊严得以维护。尊严受到侵犯的障碍包括缺乏有关其健康状况的信息、护士沟通不畅、缺乏自主权、医疗基础设施设计不良以及隐私不足。

结论

已经确定了一些促进和阻碍尊严护理的因素,这些因素在以前的研究中已经讨论过。在加纳背景下确定的独特因素是文化和宗教信仰影响下家庭成员对身体护理的参与、隐私和尊严的环境障碍以及在决策中参与不足。

临床意义

护士必须尊重老年患者,向他们传授有关健康状况的知识,让他们参与护理决策,并确定他们对提供卫生需求的偏好,特别是在考虑到宗教和文化信仰的情况下,包括家庭成员的参与。未来的医疗基础设施规划需要考虑到为患者提供舒适和隐私的残疾人无障碍套房的重要性。

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