Kuyler A, Heyns T, Johnson E
University of South Africa, Department of Inclusive Education, Pretoria, South Africa.
Department of Nursing Science, University of Pretoria, South Africa.
South Afr J Crit Care. 2024 Apr 23;40(1):e750. doi: 10.7196/SAJCC.2024.v40i1.750. eCollection 2024.
Interventions administered to critically ill patients, including mechanical ventilation, sedation or other treatments may hinder communication between patients and nurses. These communication challenges may affect critical care nurses' ability to provide compassionate, person-centred care.
To identify nurses' experiences with patients who are communication-vulnerable in the intensive care unit and how they affect nurses' ability to offer compassionate care.
This qualitative explorative descriptive study involved nurses who worked in intensive care units from four private hospitals in Gauteng, South Africa. Focus groups were conducted with 30 critical care nurses in groups of two to six participants each. Thematic analysis was used to identify themes.
Five main themes were identified based on nurses' reports of their experiences with critically ill patients who experience communication difficulties and their impact on rendering compassionate care. Themes were deductively identified based on the social purposes of communication categories. Participants indicated that communication-vulnerable patients influence their ability to provide compassionate care. Generally, the physical, emotional, social and communication difficulties of assisting communication-vulnerable patients caused nurses to feel frustrated and negative towards their work environment, which added to their work stress and sometimes resulted in compassion fatigue.
The study shows that various factors could impact the nurses' ability to provide compassionate care and that they require support to provide person-centred care. These factors can include the physical environment, the patient's alertness and awareness and institutional barriers. To support nurses in providing compassionate care, communication partner training may be warranted.
This study aims to increase awareness of the aspects that may contribute to compassion fatigue for nurses. By identifying these aspects greater support can be provided by facilities where nurses work.
对重症患者实施的干预措施，包括机械通气、镇静或其他治疗，可能会妨碍患者与护士之间的沟通。这些沟通挑战可能会影响重症护理护士提供富有同情心的、以患者为中心的护理的能力。
确定护士在重症监护病房中与存在沟通障碍的患者打交道的经历，以及这些经历如何影响护士提供富有同情心护理的能力。
这项定性探索性描述性研究涉及在南非豪登省四家私立医院重症监护病房工作的护士。对30名重症护理护士进行了焦点小组访谈，每组有两到六名参与者。采用主题分析法来确定主题。
根据护士对与存在沟通困难的重症患者打交道的经历及其对提供富有同情心护理的影响的报告，确定了五个主要主题。这些主题是根据沟通类别的社会目的演绎确定的。参与者表示，存在沟通障碍的患者会影响他们提供富有同情心护理的能力。一般来说，协助存在沟通障碍的患者所面临的身体、情感、社交和沟通困难，让护士对工作环境感到沮丧和消极，这增加了他们的工作压力，有时还导致同情疲劳。
该研究表明，多种因素可能会影响护士提供富有同情心护理的能力，他们需要支持来提供以患者为中心的护理。这些因素可能包括物理环境、患者的警觉性和意识以及制度障碍。为了支持护士提供富有同情心的护理，可能有必要进行沟通伙伴培训。
本研究旨在提高对可能导致护士同情疲劳的各方面的认识。通过识别这些方面，护士工作的机构可以提供更多支持。
