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护士对风险患者预防谵妄的优先化处理过程:一项 Q 方法研究的结果。

Nurses prioritization processes to prevent delirium in patients at risk: Findings from a Q-Methodology study.

机构信息

Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Sviluppo Professionale e Implementazione della Ricerca nelle Professioni Sanitarie (SPIR), IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Ausl Romagna, Forli, Italy.

出版信息

Geriatr Nurs. 2024 Jul-Aug;58:59-68. doi: 10.1016/j.gerinurse.2024.05.002. Epub 2024 May 18.

Abstract

BACKGROUND

This study aimed at (a) exploring how nurses prioritise interventions to prevent delirium among patients identified at risk and (b) describing the underlying prioritisation patterns according to nurses' individual characteristics.

METHODS

There was used the Q-methodology a research process following specific steps: (a) identifying the concourse, (b) the Q-sample, and (c) the population (P-set); (d) collecting data using the Q-sort table; (e) entering the data and performing the factor analysis; and (f) interpreting the factors identified.

RESULTS

There were involved 56 nurses working in medical, geriatric and log-term facilities (46; 82.2 %). The preventive intervention receiving the highest priority was 'Monitoring the vital parameters (heart rate, blood pressure, oxygen saturation)' (2.96 out of 4 as the highest priority; CI 95 %: 2.57, 3.36). Two priority patterns emerged among nurses (explained variance 44.78 %), one 'Clinical-oriented' (36.19 %) and one 'Family/caregiver-oriented' (8.60 %) representing 53 nurses out 56.

CONCLUSION

Alongside the overall tendency to prioritise some preventive interventions instead of others, the priorities are polarised in two main patterns expressing two main individual characteristics of nurses. Knowing the existence of individual patterns and their aggregation informs how to shape educational interventions.

摘要

背景

本研究旨在:(a) 探讨护士如何优先考虑针对已确定处于风险中的患者的干预措施以预防谵妄;(b) 根据护士的个体特征描述潜在的优先排序模式。

方法

本研究采用 Q 方法论,这是一种遵循特定步骤的研究过程:(a) 确定范畴;(b) Q 样本;(c) 总体(P 集);(d) 使用 Q 分类表收集数据;(e) 输入数据并进行因子分析;(f) 解释确定的因子。

结果

共有 56 名在医疗、老年和长期护理机构工作的护士参与了研究(46 名;82.2%)。优先程度最高的预防干预措施是“监测生命体征(心率、血压、血氧饱和度)”(最高优先级 2.96;95%置信区间:2.57,3.36)。在护士中出现了两种优先模式(解释方差 44.78%),一种是“临床导向”(36.19%),另一种是“家庭/照顾者导向”(8.60%),代表了 56 名护士中的 53 名。

结论

除了总体上优先考虑某些预防干预措施而不是其他措施的倾向外,优先事项还分为两种主要模式,表达了护士的两种主要个体特征。了解个体模式的存在及其聚集方式,可以为如何塑造教育干预措施提供信息。

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