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卒中病房医护人员人文关怀的心理体验:一项在中国开展的质性研究

Psychological Experience of Humanistic Care Among Medical Staff in Stroke Wards: A Qualitative Research Study Conducted in China.

作者信息

Li Min, Zhu Wen-Jing, Luo Qing, Chen Huang, Duan Yan, Xie Hong-Zhen

机构信息

Department of Nursing, Chongqing University Central Hospital, Chongqing, China.

School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China.

出版信息

Front Psychiatry. 2022 Mar 25;13:791993. doi: 10.3389/fpsyt.2022.791993. eCollection 2022.

Abstract

BACKGROUND

As a special patient group, stroke patients have a significant attachment to humanistic care. However, multiple problems remain in clinical practice. Medical staff in stroke wards are the primary providers of humanistic care. Finding out the opinions of the staff that provide these medical services is vitally important for stroke patients that need access to curative and humanistic care.

OBJECTIVE

The aim of the study is to explore the psychological experiences of doctors, nurses, and physiotherapists during the implementation of humanistic care in stroke wards.

METHOD

This is a qualitative phenomenological study. Medical staff (i.e., doctors, nurses, and physiotherapists) were selected from stroke wards in general hospitals (minimum level two) from 13 cities within six provinces in China. A purposive sampling method was used until saturation ( = 18). Face-to-face or video call semi-structured interviews were conducted by using a phenomenological research method. The average interview length was 60 min (range 30-90 min). The Colaizzi seven-step method was used for analysis.

RESULTS

Four themes and 12 sub-themes were extracted from the qualitative interviews of the medicine, nursing and technology staff, as follows. ➀ The ward staff reported that the behaviors of the stroke patients gradually improved when they assisted with stroke treatment idea changes, when they paid attention to solving the patients' existing problems, and when they took the initiative to create a caring atmosphere; ➁ when humanistic care in the stroke wards was carried out with consciousness and ability improvement (including proactive caring behaviors in which vocational value was not strong and in which the whole-person rehabilitation was given attention, not just implementation), the patients' behaviors improved; ➂ the stroke wards themselves were improved (the gap between the current management and the needs of medical institutions and the gap between the rehabilitation conditions and the patients' needs were addressed); and ➃ the urgent needs of the staff in the implementation of humanistic care in stroke wards were considered (the addition of full-time posts, the effective training of humanistic care, and the construction of a more harmonious doctor-patient relationship).

CONCLUSION

In implementing humanistic care in stroke wards, the consciousness and ability of the medical staff need to be improved. In addition, the practical problems and contradictions affecting the development of humanistic care must be addressed. To improve the level of humanistic care in stroke wards, attention should be paid to the overall improvement of the personal qualities of the medical staff and the integration of a humanistic management mode.

摘要

背景

作为一个特殊的患者群体,脑卒中患者对人文关怀有着强烈的需求。然而,临床实践中仍存在诸多问题。脑卒中病房的医护人员是人文关怀的主要提供者。了解提供这些医疗服务的工作人员的意见对于需要获得治疗和人文关怀的脑卒中患者至关重要。

目的

本研究旨在探讨医生、护士和物理治疗师在脑卒中病房实施人文关怀过程中的心理体验。

方法

这是一项质性现象学研究。从中国六个省份13个城市的综合医院(最低二级)的脑卒中病房中选取医护人员(即医生、护士和物理治疗师)。采用目的抽样法,直至达到饱和(n = 18)。运用现象学研究方法进行面对面或视频通话半结构化访谈。平均访谈时长为60分钟(范围30 - 90分钟)。采用Colaizzi七步法进行分析。

结果

从医护技人员的质性访谈中提炼出四个主题和12个子主题,具体如下。➀病房工作人员表示,当他们协助脑卒中患者转变治疗观念、关注解决患者现存问题并主动营造关怀氛围时,患者的行为逐渐改善;➁当脑卒中病房的人文关怀在意识和能力提升方面得以开展(包括职业价值不强时的主动关怀行为以及关注全人康复而非仅执行康复)时,患者的行为得到改善;➂脑卒中病房自身得到改善(解决了当前管理与医疗机构需求之间的差距以及康复条件与患者需求之间的差距);➃考虑了工作人员在脑卒中病房实施人文关怀过程中的迫切需求(增设专职岗位、进行有效的人文关怀培训以及构建更和谐的医患关系)。

结论

在脑卒中病房实施人文关怀时,医护人员的意识和能力有待提高。此外,必须解决影响人文关怀发展的实际问题和矛盾。为提高脑卒中病房的人文关怀水平,应注重医护人员个人素质的全面提升以及人文管理模式的融入。

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