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确定主题,为护理决策提供信息,以照顾接受无创通气治疗的慢性阻塞性肺疾病急性加重患者:一项定性描述性研究。

Identifying themes to inform nursing decisions when caring for patients with acute exacerbation of chronic obstructive pulmonary disease on noninvasive ventilation: A qualitative descriptive study.

机构信息

Department of Medicine, Division of Pulmonary and Critical Care, UMASS Chan Medical School-Baystate, Springfield, Massachusetts, USA.

Baystate Health, Springfield, Massachusetts, USA.

出版信息

Res Nurs Health. 2022 Dec;45(6):707-716. doi: 10.1002/nur.22260. Epub 2022 Sep 12.

Abstract

Prior studies analyzing patient experience with noninvasive ventilation (NIV) found the most impactful interaction that patients remembered was with nurses, however a survey of nurses regarding the management of patients treated with NIV has shown that most nurses felt unprepared to care for these sick patients. Our qualitative descriptive study explored the current nursing experience using NIV as a treatment for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Nine (n = 9) subject matter expert nurses practicing in a variety of clinical settings participated in semi-structured interviews. The COnsolidated criteria for REporting Qualitative research checklist was followed for interview development. Interview transcripts were subsequently analyzed using deductive thematic analysis. Themes identified from the interviews pertained to patient assessment, novice nurses' need for clinical support, team communication, and nursing education. Improving interprofessional team communication and collaboration skills, and implementing guidelines for NIV utilization were specified as essential components of NIV education for nurses. Even though the nursing role in the care of AECOPD NIV patient could be institution dependent, the themes presented in our study are useful in identifying opportunities for NIV nursing education and areas for further research. Patient or Public Contribution: Nurses served as interviewees for this study.

摘要

先前分析非侵入性通气(NIV)患者体验的研究发现,患者记忆最深刻的最具影响力的互动是与护士的互动,然而,一项针对护士管理接受 NIV 治疗的患者的调查显示,大多数护士觉得自己没有准备好照顾这些生病的患者。我们的定性描述性研究使用 NIV 作为治疗慢性阻塞性肺疾病急性加重(AECOPD)的方法,探讨了当前的护理经验。9 名(n=9)在各种临床环境中实践的主题专家护士参加了半结构化访谈。访谈的发展遵循了 COnsolidated criteria for REporting Qualitative research 清单。随后使用演绎主题分析对访谈记录进行了分析。从访谈中确定的主题涉及患者评估、新手护士对临床支持的需求、团队沟通和护理教育。提高跨专业团队沟通和协作技能,并实施 NIV 使用指南,被指定为护士接受 NIV 教育的重要组成部分。尽管在 AECOPD NIV 患者护理中,护士的角色可能取决于机构,但我们研究中提出的主题有助于确定 NIV 护理教育的机会和进一步研究的领域。患者或公众贡献:护士在这项研究中担任访谈对象。

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