School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden Holmström, Eskilstuna Västerås, Åsa, Sweden.
Department of Prehospital and Emergency Care and Area 3, Uppsala University Hospital, Uppsala, Sweden.
BMC Emerg Med. 2024 Nov 17;24(1):217. doi: 10.1186/s12873-024-01133-4.
Persons who become life-threateningly ill or injured (due to for example trauma or cardiac arrest) are cared for in hospitals' designated emergency rooms at the emergency department (ED). In these rooms, the life-threatening condition and biomedical focus may reinforce a culture that value the medical-technical care. Meeting patients fundamental care needs (integrating physical, psychosocial and relational care needs) in a person-centred way might hence be challenging in emergency rooms. Little is known about how person-centred fundamental care is experienced and valued by vulnerable and exposed patients in emergency rooms. This study aims to describe fundamental care needs experienced by patients with a life-threating condition in the emergency room.
A descriptive deductive qualitative study with individual interviews were carried out with 15 patients who had been life-threateningly ill or injured and admitted in an emergency room, in Sweden. Data collection was conducted during 2022. Transcribed interviews were analyzed with deductive content analysis, based on the Fundamentals of Care framework.
Despite being life-threateningly ill or injured, patients were still able to describe their unique needs-which were not only related to biomedical care. A relationship was established between healthcare professionals and the patient in the initial stage, but not maintained during their stay at the emergency room. Patients felt their physical needs were met to a greater extent than psychosocial and relational needs, despite their prioritizing the latter. Patients preferred personalized care but described care as task oriented. The physical environment limited patients from having their fundamental care needs met, and they adopted to a "patient role" to avoid adding to staff stress. The emergency room situation evoked existential thoughts.
This paper provides unique insights into patients' experiences of being cared for in an emergency room. From the patient perspective, physical care was not enough. Relationship, timely and personalized information, and existential needs were identified as essential fundamental care needs, which were not, or only partly met. The finding highlights the need to embed and prioritize fundamental care in practice also for patients who are life-threateningly ill or injured, which in turn calls for focus on organizational prerequisites to enable person-centred fundamental care.
患有危及生命的疾病或受伤的人（例如因创伤或心脏骤停）在医院的急诊室的指定急救室接受治疗。在这些房间里，危及生命的情况和生物医学重点可能会强化一种重视医疗技术护理的文化。因此，以以人为本的方式满足患者的基本护理需求（整合身体、心理社会和人际关系护理需求）可能具有挑战性在急诊室。对于在急诊室中脆弱和暴露的患者，基本护理的以人为本的体验和价值知之甚少。本研究旨在描述处于危及生命状态的患者在急诊室中体验到的基本护理需求。
这是一项描述性演绎定性研究，对 15 名在瑞典急诊室接受危及生命的疾病或受伤治疗的患者进行了个体访谈。数据收集于 2022 年进行。根据护理基础框架，对转录的访谈进行演绎内容分析。
尽管处于危及生命的状态，患者仍能够描述他们独特的需求——这些需求不仅与生物医学护理有关。在初始阶段，医护人员与患者建立了关系，但在他们在急诊室逗留期间并没有维持这种关系。患者感到他们的身体需求得到了更大程度的满足，而心理社会和人际关系需求则没有得到满足，尽管他们更重视后者。患者更喜欢个性化的护理，但他们描述的护理是任务导向的。物理环境限制了患者满足基本护理需求，他们采取了“患者角色”以避免增加工作人员的压力。急诊室的情况引发了存在主义的思考。
本文提供了患者在急诊室接受护理的独特视角。从患者的角度来看，身体护理是不够的。关系、及时和个性化的信息以及存在需求被确定为基本的基本护理需求，这些需求没有得到满足，或者只是部分得到满足。这一发现强调了在实践中嵌入和优先考虑基本护理的必要性，即使对于生命垂危的患者也是如此，这反过来又需要关注组织前提条件，以实现以人为本的基本护理。
