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联络护士在病房工作人员因未识别谵妄而难以与患者建立治疗关系时进行协调干预:一项案例研究

Intervention of Coordination by Liaison Nurse Where Ward Staff Struggled to Establish a Therapeutic Relationship with a Patient Because of Failure to Recognize Delirium: A Case Study.

作者信息

Nakai Yuri, Nitta Yusuke, Hashimoto Reiko

机构信息

Faculty of Nursing, University of Kochi, 2751-1 Ike, Kochi City 780-8515, Japan.

Department of Neuropsychiatry, Kanazawa Medical University, 1-1 Uchinada, Kahoku 920-0265, Japan.

出版信息

Healthcare (Basel). 2022 Jul 18;10(7):1335. doi: 10.3390/healthcare10071335.

Abstract

In this case study, ward staff found it difficult to establish a therapeutic relationship with a patient with advanced gastric cancer because they misdiagnosed delirium as a psychogenic reaction to the cancer diagnosis. This article reports on the process and effects of intervention by a liaison nurse. The liaison nurse recognized the misdiagnosis and approached the ward staff via a psychiatrist-led team. This enabled rapid revision of the treatment policy. The liaison nurse contributed to the continuation of treatment by enabling the ward staff and patient to understand each other better and to collaborate to build a relationship and control the patient's mental health symptoms, including attention disorder and excessive demands. The patient and family had different views on discharge because of the patient's mental health issues. The liaison nurse encouraged the ward staff to inform the family caregiver about the patient's medical condition, the expected future course of the disease, and likely symptoms, and provide appropriate professional services. This enabled the patient to be discharged in line with their wishes. This case highlights the role of the liaison nurse in coordinating care and helping ward staff to recognize symptoms and provide appropriate care and support for patients and their families.

摘要

在本案例研究中,病房工作人员发现很难与一名晚期胃癌患者建立治疗关系,因为他们将谵妄误诊为对癌症诊断的心理反应。本文报告了联络护士的干预过程及效果。联络护士识别出了误诊情况,并通过一个由精神科医生主导的团队与病房工作人员沟通。这使得治疗政策得以迅速修订。联络护士通过让病房工作人员和患者更好地相互理解、协作建立关系并控制患者的心理健康症状(包括注意力障碍和过度需求),为治疗的持续进行做出了贡献。由于患者的心理健康问题,患者及其家属对出院有不同看法。联络护士鼓励病房工作人员向家庭照顾者告知患者的病情、疾病未来可能的发展过程以及可能出现的症状,并提供适当的专业服务。这使得患者能够如愿出院。本案例凸显了联络护士在协调护理以及帮助病房工作人员识别症状并为患者及其家属提供适当护理和支持方面的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe2e/9319112/4a02192653bc/healthcare-10-01335-g001.jpg

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