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护士如何体验急诊科的关系性工作——定性研究

How Do Nurses Experience Relational Work in the Emergency Department-Qualitative Study.

作者信息

Gamst-Jensen Hejdi, Thise Rasmussen Marie Louise, Konradsen Hanne, Poulsen Ingrid

出版信息

J Emerg Nurs. 2025 Jan;51(1):105-113. doi: 10.1016/j.jen.2024.07.006. Epub 2024 Aug 30.

DOI:10.1016/j.jen.2024.07.006
PMID:39217535
Abstract

INTRODUCTION

This study aimed to explore how nurses experience relational work in the emergency department.

METHODS

A qualitative design with 34 focus group interviews using an abductive thematic analysis were completed for this study. Participants were recruited from an annual mandatory continuous learning program in 2020-2022 at 2 university hospitals in the Capital Region of Denmark. We applied semistructured interviews in an instructor-supported reflection session on the topic "relational nursing care." Group discussion was supported by an interview guide addressing key elements of the nurse-patient relationship as described in the fundamentals of care framework.

RESULTS

Acute care nurses' attention was primarily directed toward the initial patient assessment, rather than toward the later stages of the patient trajectory. Forming a relationship with the patient was highly individual and done at the discretion of each nurse. The key elements of relational nursing were not mutually exclusive, but the findings could be separated into biomedical and relational care, where biomedical tasks took precedence.

DISCUSSION

Relational care in the emergency department is optional and individually performed. Moreover, emergency nurses lack a vocabulary to express this type of work. Consequently, there is a risk that patients' psychosocial needs are not sufficiently met. According to the emergency nurses participating in this study, nurses fall short when performing and describing relational care. Nurses need more knowledge to address the psychosocial patient needs during short-term hospital admissions. Relational care and patient centeredness also need to be acknowledged by nursing leaders and further developed.

摘要

引言

本研究旨在探讨护士在急诊科如何体验关系性工作。

方法

本研究采用定性设计,通过归纳主题分析完成了34次焦点小组访谈。参与者是从2020 - 2022年丹麦首都地区2所大学医院的年度强制性持续学习项目中招募的。我们在关于“关系性护理”主题的教师支持的反思会议中应用了半结构化访谈。小组讨论由一份访谈指南支持,该指南涉及护理框架基础中描述的护患关系的关键要素。

结果

急诊护士的注意力主要集中在对患者的初始评估上,而不是患者病程的后期阶段。与患者建立关系高度个体化,由每位护士自行决定。关系性护理的关键要素并非相互排斥,但研究结果可分为生物医学护理和关系性护理,其中生物医学任务占优先地位。

讨论

急诊科的关系性护理是可选择的且由个人执行。此外,急诊护士缺乏表达这类工作的词汇。因此,存在患者心理社会需求未得到充分满足的风险。根据参与本研究的急诊护士的说法,护士在执行和描述关系性护理方面存在不足。护士在短期住院期间满足患者心理社会需求方面需要更多知识。关系性护理和以患者为中心也需要得到护理领导者的认可并进一步发展。

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