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被束缚——在重症监护病房接受机械通气时被身体约束的经历。

Being tied down-The experience of being physically restrained while mechanically ventilated in ICU.

作者信息

Perez Dawn, Murphy Gillian, Wilkes Lesley, Peters Kath

机构信息

School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia.

School of Nursing and Midwifery/Translational Health Research Institute (THRI), Western Sydney University, Penrith, New South Wales, Australia.

出版信息

J Adv Nurs. 2022 Nov;78(11):3760-3771. doi: 10.1111/jan.15354. Epub 2022 Jul 5.

Abstract

AIMS

To explore the experience of physical restraints during mechanical ventilation in intensive care from the perspectives of patients and family members.

DESIGN

This research was a qualitative study with a naturalistic inquiry framework adhering to the Consolidated Criteria for Reporting Qualitative Research guidelines.

METHOD

In-depth, semi-structured conversations were conducted with five patients and six family members who had either personally experienced or witnessed their loved ones being physically restrained during mechanical ventilation in intensive care. Data collection occurred between March 2018 and June 2019. These conversations were audio-recorded and transcribed. Reflexive thematic analysis was used to analyse the data.

RESULTS

Three major themes emerged from the data. These themes were: Being tied down; Feeling helpless; and Finding light in the darkness.

CONCLUSION

The experience of physical restraints during mechanical ventilation in intensive care leads to traumatic experiences which can impact patients and families long after their ICU stay. Holistic care, which considers the physical, emotional and psychological needs of patients and families, should be more thoroughly explored when managing treatment interference to minimize harm.

IMPACT

This study gained insight into the physical, emotional and psychological consequences of applying physical restraints to patients who are mechanically ventilated as an intervention for preventing treatment interference. The findings of this study have the potential to improve ICU patient and family outcomes by influencing current physical restraint practices. Recommendations from this research can contribute to practice change by informing policy, shifting workplace culture and norms about restraints, and encouraging education and training.

摘要

目的

从患者及其家属的角度探讨重症监护中机械通气期间使用身体约束的体验。

设计

本研究是一项定性研究,采用自然主义探究框架,遵循《定性研究报告统一标准》指南。

方法

对五名患者和六名家属进行了深入的半结构化访谈,这些患者或家属亲身经历过或目睹过亲人在重症监护中机械通气期间受到身体约束。数据收集于2018年3月至2019年6月期间进行。这些访谈进行了录音和转录。采用反思性主题分析法对数据进行分析。

结果

数据中出现了三个主要主题。这些主题是:被束缚;感到无助;在黑暗中寻找光明。

结论

重症监护中机械通气期间使用身体约束的经历会导致创伤性体验,这种体验在患者和家属离开重症监护病房很久之后仍会产生影响。在处理治疗干扰时,应更全面地探索考虑患者及其家属身体、情感和心理需求的整体护理,以尽量减少伤害。

影响

本研究深入了解了对接受机械通气的患者使用身体约束作为预防治疗干扰干预措施所产生的身体、情感和心理后果。本研究的结果有可能通过影响当前的身体约束实践来改善重症监护病房患者及其家属的结局。本研究的建议可通过为政策提供信息、改变关于约束的工作场所文化和规范以及鼓励教育和培训来促进实践变革。

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