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大流行期间家庭陪伴受限情况下护士对临终关怀的看法:一项定性研究

Nurses' perspectives about end-of-life care when family presence is restricted during a pandemic: A qualitative study.

作者信息

Choi Myung Hui, Kim Hyun Jung, Yoo Hye Jin

机构信息

Department of Nursing, Dankook University Hospital, Cheonan, Republic of Korea.

College of Nursing, Dankook University, Cheonan, Republic of Korea.

出版信息

Aust Crit Care. 2025 Jan;38(1):101091. doi: 10.1016/j.aucc.2024.06.012. Epub 2024 Aug 10.

Abstract

BACKGROUND

To prevent the infection from spreading, patients who were dying from COVID-19 were treated in isolation with restricted family access, which differed from existing end-of-life care procedures. This was a significant change that affected the care provided by nurses.

OBJECTIVES

This study explored nurses' end-of-life care experiences in a limited family visitation setting during the COVID-19 pandemic.

METHODS

A descriptive qualitative study was conducted. Data were collected through individual, in-depth, semistructured interviews with ten critical care nurses who provided end-of-life care to patients with COVID-19 in South Korea. The data were analysed using thematic analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used to assess the study's rigour.

FINDINGS

Three themes were identified: 'Witnessing patients' and families' heartbreak over separation', 'The gaps between the ideals and realities of end-of-life care', and 'Efforts to provide patients with a comfortable final journey'. Nurses realise the importance of their central role in supporting interactions between patients and families during end-of-life care.

CONCLUSIONS

Family participation, facilitated by nurses' interest and efforts as mediators connecting patients and families, is essential for achieving high-quality care for inpatients facing end of life. This study is significant as it emphasises that the direction of end-of-life care should be family centric, even in a pandemic situation with limited family participation. To improve interaction between patients and families, creating an environment based on family participation that builds trust and strengthens communication is essential. Additionally, hospital support, such as professional education and counselling, should be provided to strengthen nurses' end-of-life care competency.

摘要

背景

为防止感染扩散,新冠肺炎临终患者在隔离状态下接受治疗,家属探视受限,这与现有的临终关怀程序不同。这是一项重大改变,影响了护士提供的护理。

目的

本研究探讨了新冠肺炎疫情期间,在有限家属探视环境下护士的临终关怀经历。

方法

开展了一项描述性定性研究。通过对在韩国为新冠肺炎患者提供临终关怀的10名重症监护护士进行个人深度半结构化访谈收集数据。采用主题分析法对数据进行分析。使用《定性研究报告统一标准》清单评估研究的严谨性。

结果

确定了三个主题:“见证患者和家属因分离而心碎”、“临终关怀理想与现实之间的差距”以及“努力为患者提供舒适的最后旅程”。护士意识到自己在临终关怀期间支持患者与家属互动方面的核心作用的重要性。

结论

护士作为连接患者和家属的调解人,通过自身的关注和努力促进家属参与,对于为临终住院患者提供高质量护理至关重要。本研究具有重要意义,因为它强调即使在家属参与有限的疫情情况下,临终关怀的方向也应以家庭为中心。为改善患者与家属之间的互动,营造基于家属参与、建立信任并加强沟通的环境至关重要。此外,应提供医院支持,如专业教育和咨询,以增强护士的临终关怀能力。

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