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医院和家庭护理护士在患者及家属参与医院与市政当局之间过渡过程中的经历:一项定性研究。

Hospital and homecare nurses' experiences of involvement of patients and families in transition between hospital and municipalities: A qualitative study.

作者信息

Petersen Julie Jacoby, Østergaard Birte, Svavarsdóttir Erla Kolbrún, Palonen Mira, Brødsgaard Anne

机构信息

Department of Surgical Gastroenterology, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark.

Section for Nursing, Department of Public Health, University of Aarhus, Aarhus, Denmark.

出版信息

Scand J Caring Sci. 2023 Mar;37(1):196-206. doi: 10.1111/scs.13130. Epub 2022 Nov 9.

Abstract

BACKGROUND

Involving patients and families in nursing care is essential to improve patients' health outcomes. Furthermore, families play an essential role in supporting patients by helping nurses understand the patient's everyday life. However, families also need support. Involvement of patients and families is especially important when patients are transferred between hospital and home as transitions heighten the risk of compromising quality and safety in care. However, no consensus exists on how to involve them. Consequently, this may challenge a systematic approach toward patient and family involvement.

AIM

To describe hospital and homecare nurses' experiences with involving patients and their family members in nursing care in the transition between hospital and municipalities.

METHOD

Focus group interviews were conducted in the Gastro unit at a large university hospital in Denmark. Participants included 10 hospital nurses from three wards at the Gastro unit and six homecare nurses from one of three municipalities in the hospital catchment area (total n = 16). Data were analysed using qualitative content analysis. The study is reported according to the Consolidated Criteria for Reporting Qualitative Research.

FINDINGS

Our analysis revealed one overall theme - "The complexity of involvement" - based on four categories: gap between healthcare sectors increases the need for patient and family involvement, lack of time is a barrier to patient and family involvement, involvement is more than information, and involvement as a balancing act.

CONCLUSION

The nurses experienced patients' and families' involvement as essential, but a discrepancy was found between nurses' intentions and their actions. Aspects related to a gap between healthcare sectors and various understandings of involvement challenged the systematic involvement of patients and families in the transition between healthcare sectors. However, the nurses were highly motivated to achieve a close cross-sectoral collaboration and to show commitment towards patients and families.

摘要

背景

让患者及其家属参与护理对于改善患者的健康结局至关重要。此外,家属在支持患者方面发挥着重要作用,他们帮助护士了解患者的日常生活。然而,家属自身也需要支持。当患者在医院和家庭之间转移时,患者及其家属的参与尤为重要,因为这种过渡会增加护理质量和安全受损的风险。然而,对于如何让他们参与,目前尚无共识。因此,这可能会对患者和家属参与的系统方法构成挑战。

目的

描述医院和家庭护理护士在医院与市政当局之间的过渡阶段让患者及其家属参与护理的经验。

方法

在丹麦一家大型大学医院的胃肠科进行了焦点小组访谈。参与者包括来自胃肠科三个病房的10名医院护士和来自医院服务区域内三个市政当局之一的6名家庭护理护士(共16人)。采用定性内容分析法对数据进行分析。本研究按照《定性研究报告统一标准》进行报告。

结果

我们的分析揭示了一个总体主题——“参与的复杂性”——基于四个类别:医疗保健部门之间的差距增加了患者和家属参与的必要性、时间不足是患者和家属参与的障碍、参与不仅仅是提供信息,以及参与是一种平衡行为。

结论

护士们认为患者及其家属的参与至关重要,但发现护士的意图与行动之间存在差异。与医疗保健部门之间的差距以及对参与的各种理解相关的方面,对患者和家属在医疗保健部门之间过渡阶段的系统参与构成了挑战。然而,护士们有很高的积极性来实现密切的跨部门合作,并对患者及其家属表现出承诺。

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