当护士感到担忧时：临床病情恶化中直觉的概念分析
When Nurses Worry: A Concept Analysis of Intuition in Clinical Deterioration.
作者信息
Byrne Amy-Louise, Massey Deb, Flenady Tracy, Connor Justine, Chua Wei Ling, Lagadec Danielle Le
机构信息
School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton, Queensland, Australia.
Edith Cowen University, Joondalup, Western Australia, Australia.
出版信息
J Adv Nurs. 2025 Aug;81(8):4566-4583. doi: 10.1111/jan.16956. Epub 2025 Apr 10.
BACKGROUND
Nurse worry is a criterion often included in early warning systems tools and used to escalate care when other clinical markers do not indicate deterioration. What it means to worry, however, is not always clear.
AIMS
To generate a concept analysis of nurse worry in relation to clinical deterioration.
DESIGN
Rodgers's evolutionary method was used.
METHOD
A review was first conducted in April 2024, searching the Cumulative Index for Nursing and Allied Health Literature, Pubmed, EmCare, and Embase databases. A total of 22 articles were subjected to analysis of the antecedents, attributes, and consequences of nurse worry in the context of clinical deterioration. The processes of nurse worry were subsequently mapped and conceptualised, leading to a descriptive statement of nurse worry.
RESULTS
Worry captures a nurse's sense of knowing the patient and is embodied via assessing, sensing, recognising, and processing information, cues, and patterns.
CONCLUSION
Nurse worry is a complex process, impacted by external and internal factors. Implications for the profession or patient care: Assured practice, driven by validation of a nurse's worry, leads to proactive care of the deteriorating patient, whereas apprehensive practice, driven by fear and trepidation, leads to reactive care of the deteriorating patient.
IMPACT
Nurse worry is a criterion often included in early warning systems tools and used to escalate care when other clinical markers do not indicate clinical deterioration. What it means to worry, however, is not always clear. From the concept analysis, a descriptive statement of nurse worry emerged. Worry captures a nurse's sense of knowing the patient and is embodied via assessing, sensing, recognising, and processing information, cues, and patterns.
IMPLICATIONS FOR THE PROFESSION OR PATIENT CARE
This research has implications for nurses, policymakers, and organisations, as nurse worry is an important element in detecting clinical deterioration. Nurse worry must be organisationally supported.
REPORTING METHODS
PRISMA Extension for Scoping Reviews (PRISMA-SCR).
PATIENT OR PUBLIC CONTRIBUTION
No Patient or Public Contribution.
背景
护士的担忧是早期预警系统工具中经常包含的一个标准，当其他临床指标未显示病情恶化时，用于提升护理级别。然而，担忧意味着什么并不总是明确的。
目的
对与临床恶化相关的护士担忧进行概念分析。
设计
采用罗杰斯的进化方法。
方法
2024年4月首次进行综述，检索护理及相关健康文献累积索引、PubMed、EmCare和Embase数据库。共22篇文章被用于分析临床恶化背景下护士担忧的前因、属性和后果。随后绘制并概念化了护士担忧的过程，得出了护士担忧的描述性陈述。
结果
担忧体现了护士对患者的了解，通过评估、感知、识别和处理信息、线索及模式来体现。
结论
护士担忧是一个复杂的过程，受到外部和内部因素的影响。对专业或患者护理的启示：由对护士担忧的验证驱动的自信实践会促成对病情恶化患者的积极护理，而由恐惧和不安驱动的忧虑实践会导致对病情恶化患者的被动护理。
影响
护士担忧是早期预警系统工具中经常包含的一个标准，当其他临床指标未显示临床恶化时，用于提升护理级别。然而，担忧意味着什么并不总是明确的。通过概念分析，得出了护士担忧的描述性陈述。担忧体现了护士对患者的了解，通过评估、感知、识别和处理信息、线索及模式来体现。
对专业或患者护理的启示
这项研究对护士、政策制定者和组织具有启示意义，因为护士担忧是检测临床恶化的重要因素。护士担忧必须得到组织的支持。
报告方法
系统综述扩展版的PRISMA（PRISMA-SCR）。
患者或公众参与
无患者或公众参与。
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