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患者与救护车临床医生之间的关怀关系和互动:从以人为本的角度进行的定性综合分析。

Care relationship and interaction between patients and ambulance clinicians: A qualitative meta-synthesis from a person-centred perspective.

机构信息

School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden.

FALCK Ambulance Stockholm, Hägersten, Sweden.

出版信息

Scand J Caring Sci. 2024 Mar;38(1):24-34. doi: 10.1111/scs.13225. Epub 2023 Nov 23.

Abstract

BACKGROUND

Ambulance care is characterised by disaster medicine, traumatology and care for acute illnesses and accidents. The focus of ambulance care is clearly on medical care, whereas interpersonal interaction between patients and ambulance clinicians appears less prioritised. A patient within ambulance care needs to be listened to, be taken seriously, be treated with empathy and be seen as a unique person. These are fundamental to delivering Person-centred care.

AIM

The purpose is to describe how the care relationship and interaction between patients and ambulance clinicians in prehospital emergency care are described in the literature and how they can be interpreted from a person-centred perspective.

DATA SOURCES AND REVIEW METHODS

A qualitative meta-synthesis was used. Data collection was carried out with PubMed, CINAHL Plus and Web of Science in September-October 2022 and in August-September 2023. The first article searching applied a timeline 1990-2022 and the second applied a timeline 2022-2023. A total of 13 studies employing a qualitative approach were evaluated and included in the interpretive analysis.

RESULTS

Three themes were identified: A good care relationship, Decision-making and Hindrances to practising person-centred care in ambulance care. Trust, good communication and respect for patients' dignity were the most important parts of the good care relationship between patients and ambulance clinicians. Decision-making regarding the examination of patients, medical treatment and transport to the receiving care unit was one of the tasks that ambulance clinicians do independently but in cooperation with patients and family members. Person-centred care within ambulance care may be hindered due to environmental factors, attitudes and behaviour of ambulance clinicians and patient-related factors.

CONCLUSION

Many ambulance clinicians have already adopted Person-centred care, but several factors can hinder Person-centred care in interactions with patients. Although the results build on a limited number of studies, they indicate that person-centred care needs to be further developed and studied for high-quality ambulance care.

摘要

背景

救护车护理的特点是灾难医学、创伤学以及急性疾病和事故的护理。救护车护理的重点显然是医疗护理,而患者与救护车临床医生之间的人际互动则显得不那么重要。在救护车护理中,患者需要被倾听、被认真对待、被给予同理心,并被视为一个独特的人。这些都是提供以患者为中心的护理的基础。

目的

目的是描述在院前急救中患者与救护车临床医生之间的护理关系和互动是如何在文献中描述的,以及如何从以人为本的角度对其进行解释。

数据来源和综述方法

使用定性元综合法。数据收集于 2022 年 9 月至 10 月和 2023 年 8 月至 9 月期间在 PubMed、CINAHL Plus 和 Web of Science 上进行。第一次文章搜索应用了 1990-2022 年的时间线,第二次应用了 2022-2023 年的时间线。共评估并纳入了 13 项采用定性方法的研究进行解释性分析。

结果

确定了三个主题:良好的护理关系、决策以及救护车护理中实践以人为本护理的障碍。信任、良好的沟通和尊重患者的尊严是患者与救护车临床医生之间良好护理关系的最重要部分。对患者检查、医疗和转运到接收护理单元的决策是救护车临床医生独立但与患者和家属合作完成的任务之一。由于环境因素、救护车临床医生的态度和行为以及患者相关因素,救护车护理中的以人为本护理可能会受到阻碍。

结论

许多救护车临床医生已经采用了以人为本的护理,但有几个因素可能会阻碍与患者的以人为本护理。尽管这些结果基于有限数量的研究,但它们表明以人为本的护理需要进一步发展和研究,以实现高质量的救护车护理。

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