公共卫生应急背景下一线护士的决策疲劳体验：一项诠释现象学分析
Decision fatigue experience of front-line nurses in the context of public health emergency: an interpretative phenomenological analysis.
作者信息
Dong Shan-Shan, Wang Kun, Zhang Ke-Qiang, Wang Xing-Hui, Wang Jian-Hang, Turdi Subinur, Yang Jia-Yu, He Li, Yan Rong, Li Yue-Wei
机构信息
Hepatopancreatobiliary Surgery Department, General External Center, First Hospital of Jilin University, Changchun, Jilin Province, China.
Pediatric Respiratory Department, Children's Hospital, First Hospital of Jilin University, Changchun, Jilin Province, China.
出版信息
BMC Nurs. 2024 Aug 13;23(1):553. doi: 10.1186/s12912-024-02163-w.
BACKGROUND
Decision fatigue is a new concept in the field of psychology and refers to a state of fatigue alongside impaired cognitive processing and emotional regulation ability. Previous studies have confirmed that nurses are prone to decision fatigue, and nurses who experience decision fatigue may implement nursing measures that are inconsistent with clinical evidence, thus affecting patients' benefits. COVID-19, as a large-scale global public health emergency, increased the workload and burden of nurses and aggravated decision fatigue. However, the factors leading to decision fatigue among nurses have not yet been identified.
METHODS
This study is guided by interpretative phenomenology. During the epidemic period of COVID-19: From November 2022 to February 2023, a one-to-one, semi-structured in-depth interview was conducted among nurses with decision fatigue experience who were participating in front-line work in Jilin Province using homogenous sampling. The interview recordings and related data were transcribed into text within 24 h, and data analysis was assisted by NVivo 12.0 software.
RESULTS
After a total of 14 front-line nurses were analyzed in this study, The thematic level reaches saturation, the findings present a persuasive and coherent narrative, and the study is terminated, and finally extracted and formed three core themes: "Cognition, influence and attitude of decision fatigue", "Approaching factors of decision fatigue" and "Avoidant factors of decision fatigue".
CONCLUSION
This study confirmed that decision fatigue was widespread in the work of front-line nurses, affecting the physical and psychological health of nurses, the quality of nursing work, the degree of benefit of patients and the clinical outcome. However, nursing staff do not know enough about decision fatigue, so the popularization and research of decision fatigue should be strengthened. Improve the attention of medical institutions, nursing managers and nursing staff.Some suggestions are put forward for the intervention of decision fatigue through personnel, task, tool and technology, organization and environment.
背景
决策疲劳是心理学领域的一个新概念，指的是一种伴随着认知加工和情绪调节能力受损的疲劳状态。以往研究证实护士容易出现决策疲劳，经历决策疲劳的护士可能会实施与临床证据不一致的护理措施，从而影响患者的利益。新型冠状病毒肺炎（COVID-19）作为一场大规模的全球突发公共卫生事件，增加了护士的工作量和负担，加重了决策疲劳。然而，导致护士决策疲劳的因素尚未明确。
方法
本研究以诠释现象学为指导。在COVID-19疫情期间：2022年11月至2023年2月，采用同质抽样的方法，对吉林省参与一线工作且有决策疲劳经历的护士进行一对一、半结构化深入访谈。访谈录音及相关资料在24小时内转录成文本，并借助NVivo 12.0软件进行数据分析。
结果
本研究共分析了14名一线护士后，主题层面达到饱和，研究结果呈现出有说服力且连贯的叙述，研究终止，最终提炼并形成了三个核心主题：“决策疲劳的认知、影响及态度”“决策疲劳的趋近因素”和“决策疲劳的回避因素”。
结论
本研究证实决策疲劳在一线护士工作中普遍存在，影响护士身心健康、护理工作质量、患者受益程度及临床结局。然而，护理人员对决策疲劳了解不足，因此应加强决策疲劳的普及与研究。提高医疗机构、护理管理者及护理人员的重视程度。通过人员、任务、工具与技术、组织与环境等方面对决策疲劳的干预提出了一些建议。
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