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急救员在患者复苏期间和之后与重要他人的互动,以及患者死亡时。

Paramedic interactions with significant others during and after resuscitation and death of a patient.

机构信息

Monash University, Wellington Road, Clayton, Victoria 3800, Australia.

Monash University, Wellington Road, Clayton, Victoria 3800, Australia.

出版信息

Australas Emerg Care. 2023 Jun;26(2):113-118. doi: 10.1016/j.auec.2022.08.007. Epub 2022 Sep 8.

Abstract

BACKGROUND

Out-of-hospital cardiac arrest often occurs at home, requiring paramedics to interact with family members and bystanders during resuscitation and inform them should the patient die. This study explores how paramedics navigate interactions and the changing needs of the patient and the bereaved.

METHODS

Phenomenological methodology inspired individual, semi-structured interviews. Data was then coded using reflexive thematic analysis.

RESULTS

Ten individual interviews with working paramedics with an average of 7.2 years of experience were analysed and resulted in four overarching themes. These themes encompassed communication goals and factors affecting their implementation. Four themes emerged: maximising patient outcome, minimising psychological trauma for significant others, paramedic engagement and communicating across cultures. Communication goals shift from maximising patient outcome to minimising psychological trauma for significant others during the resuscitation. Implementation of those goals is affected by paramedic engagement and communicating across cultures.

CONCLUSIONS

Paramedics used communication techniques based on personal and professional experiences, attempting to navigate limited resources, factors affecting paramedic engagement and a perceived lack of education and support in matters of grief and death.

摘要

背景

院外心脏骤停常发生在家庭中,这就要求急救人员在复苏过程中与家庭成员和旁观者进行互动,并在患者死亡时通知他们。本研究探讨了急救人员如何应对患者和死者家属的互动以及不断变化的需求。

方法

受现象学方法的启发,采用个体半结构化访谈。然后使用反思性主题分析对数据进行编码。

结果

对 10 名具有平均 7.2 年工作经验的在职急救人员进行了单独访谈,分析结果得出了四个总体主题。这些主题涵盖了沟通目标以及影响其实施的因素。出现了四个主题:最大限度地提高患者的结果,最大限度地减少对其他重要人物的心理创伤,急救人员的参与以及跨文化沟通。在复苏过程中,沟通目标从最大限度地提高患者的结果转变为最大限度地减少对其他重要人物的心理创伤。沟通目标的实施受到急救人员的参与以及跨文化沟通的影响。

结论

急救人员根据个人和专业经验使用沟通技巧,试图应对有限的资源,影响急救人员参与的因素以及在悲伤和死亡方面缺乏教育和支持的问题。

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