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护士教育者在临终关怀中的体验洞察:一项定性研究。

Insights into the experiences of nurse educators in end-of-life care: A qualitative study.

机构信息

Tokai University School of Medicine, Faculty of Nursing, Shimokasuya 143, Isehara, Kanagawa 259-1193, Japan.

出版信息

Nurse Educ Pract. 2024 May;77:103980. doi: 10.1016/j.nepr.2024.103980. Epub 2024 Apr 22.

Abstract

AIM

This study elucidated the experience of nurse educators instructing practicums for nursing students assigned to the care of end-of-life patients in fundamental nursing education.

BACKGROUND

With the growing population of older adults and increased mortality, nurses providing care for people at the end-of-life stage and their families (referred to as end-of-life nursing) will be increasingly important in Japanese healthcare settings. Acquiring knowledge and action-level methods can be insufficient for nursing students to approach the illness experiences of people at the end of their life and their families, increasing the importance of practicum in end-of-life nursing to enable learning from experience. This situation raised the need to study how nurse educators for nursing care for end-of-life patients experience the situation and what they practice as observed through the educator's standpoint to devise better teaching methods for end-of-life nursing practica.

DESIGN

Interpretative phenomenology was used.

METHODS

Semi-structured interviews were conducted with six nurse educators. Participants were interviewed about their experiences in teaching nursing students who care for people in the final stages of life. Data were analyzed using Benner's Interpretive phenomenological approach.

RESULTS

Nurse educators teaching students assigned to end-of-life patients experienced the [sudden appearance of patients themselves] and were involved in the nursing care for these end-of-life patients. They [seized the opportune "moments" for teaching] while [placing the value of practicum in end-of-life nursing in the "fragments" that students find] and then acknowledged that students were becoming aware of the core values of end-of-life nursing, even though they could not perform the techniques of care. Nurse educators also [recognized students as learners at the "borderline stage"] who are still distinct from nurses and valued students in their current state of development with hopes and expectations for further growth.

CONCLUSIONS

This study highlighted the importance of nurse educators leveraging their practical knowledge to provide direct guidance to nursing students in clinical settings. The educators approached patient care with intentionality, prioritizing the well-being of patients while engaging in co-existent care alongside the students. Simultaneously, they respected the nursing students in their transition to becoming nurses, harboring hopes and expectations for continued growth. Concurrently, they were curious about the patient and student. They sought to balance the interests of the two parties representing dissimilar temporality, thereby applying their intuitive embodied intelligence into practice. Such experiences were also interpreted from the temporality of nursing students in a transitional stage of becoming nurses.

摘要

目的

本研究阐明了基础护理教育中,护士教育者指导护理学生照顾临终患者实习的经验。

背景

随着老年人口的增加和死亡率的上升,在日本的医疗保健环境中,为生命末期患者及其家属提供护理(称为临终护理)的护士将变得越来越重要。对于护理学生来说,仅仅获得知识和行动层面的方法可能不足以让他们了解生命末期患者及其家属的疾病体验,因此,临终护理实习对于从经验中学习变得至关重要。这种情况使得有必要研究临终患者护理的护士教育者如何体验这种情况,以及他们从教育者的角度观察到什么,并实践什么,从而为临终护理实习制定更好的教学方法。

设计

采用解释现象学方法。

方法

对 6 名护士教育者进行半结构化访谈。访谈内容为他们在教授护理学生照顾生命末期患者方面的经验。使用 Benner 的解释现象学方法对数据进行分析。

结果

教授临终患者护理学生的护士教育者体验到了[患者本人的突然出现],并参与了对这些临终患者的护理。他们[抓住教学的“时机”],同时[将临终护理实习的价值置于学生发现的“碎片”中],然后意识到学生正在意识到临终护理的核心价值,尽管他们不能执行护理技术。护士教育者还[将学生视为处于“边缘阶段”的学习者],他们仍然与护士不同,并在学生当前的发展阶段重视他们,希望并期望他们进一步成长。

结论

本研究强调了护士教育者利用其实践知识为护理学生在临床环境中提供直接指导的重要性。教育者有意识地接近患者护理,在与学生共同进行共存护理的同时,优先考虑患者的福祉。同时,他们尊重正在过渡为护士的护理学生,对他们的持续成长抱有希望和期待。同时,他们对患者和学生都很好奇。他们试图平衡代表不同时间性的双方的利益,从而将他们的直观体智应用于实践中。这些经验也从处于成为护士过渡阶段的护理学生的时间性方面进行了解释。

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