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重症服务中的综合护理:一项西班牙的定性研究。

Comprehensive Care in Critical Services: A Spanish Qualitative Study.

作者信息

de Diego-Cordero Rocío, Flores-Alpresa Thalía, Fernández-Rodríguez Miriam, Vega-Escaño Juan, Pérez-Jiménez José Miguel

机构信息

Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain.

Research Group CTS1149: Comprehensive and Sustainable Health: Bio-Psycho-Social, Cultural and Spiritual Approach to Human Development, 41009 Seville, Spain.

出版信息

Healthcare (Basel). 2025 Mar 27;13(7):745. doi: 10.3390/healthcare13070745.

Abstract

BACKGROUND/OBJECTIVES: Comprehensive care is crucial in emergency healthcare. In intensive care units, a holistic approach may be difficult to implement due to the conditions of the patients and existing work protocols aimed at maintaining vital functions for the survival of patients. The present study aims to explore and describe the knowledge, attitudes, and perceptions of critical care and emergency health professionals regarding the implementation of integrated care practices within intensive care units, with the goal of identifying barriers and facilitators to adopting a holistic approach in emergency healthcare settings.

METHODS

This study implemented an exploratory and descriptive qualitative design with a phenomenological approach through semi-structured interviews with health professionals who had worked in intensive care units or emergency services for both public and private health institutions in Spain (n = 25). The study was conducted during the years 2023 and 2024, using a convenience sampling method along with snowball sampling, and a narrative discourse analysis was performed. The MAXQDA 2022 software program was used. This study was granted due permission by the Research Ethics Committee belonging to the Junta de Andalucía, under protocol code 0768-N-20.

RESULTS

The total sample consisted of 25 healthcare professionals from critical care and emergency services in Spain. The main themes, as key findings, were knowledge and perception, determining factors, resources and infrastructure, the bioethical dimension, perspectives on comprehensive care, and multidimensional impact. Most of the professionals were familiar with comprehensive care, but lack of resources and time prevented them from carrying it out in their units.

CONCLUSIONS

For critical care and emergency professionals, comprehensive care is important to their clinical practice, but barriers to its realization still exist. Understanding the importance to these professionals of the application of comprehensive care is fundamental to establishing measures for its implementation in these services. It is also a motivation to continue providing humanized and compassionate care that respects the patient's dignity. It is a priority to provide the necessary infrastructure and human resources so that patients admitted to these units can be cared for with this tool.

摘要

背景/目的:综合护理在紧急医疗保健中至关重要。在重症监护病房,由于患者的病情以及旨在维持患者生命功能以确保生存的现有工作流程,全面的护理方法可能难以实施。本研究旨在探索和描述重症监护和急诊医疗专业人员对重症监护病房内实施综合护理实践的知识、态度和看法,以确定在紧急医疗环境中采用整体护理方法的障碍和促进因素。

方法

本研究采用探索性和描述性定性设计,采用现象学方法,通过对在西班牙公立和私立医疗机构的重症监护病房或急诊服务部门工作的卫生专业人员进行半结构式访谈(n = 25)。该研究在2023年和2024年进行,采用便利抽样和滚雪球抽样方法,并进行了叙事话语分析。使用了MAXQDA 2022软件程序。本研究已获得安达卢西亚自治区研究伦理委员会的正式批准,协议代码为0768-N-20。

结果

总样本包括来自西班牙重症监护和急诊服务部门的25名医疗保健专业人员。作为主要发现的主要主题包括知识与认知、决定因素、资源与基础设施、生物伦理维度、综合护理的观点以及多维影响。大多数专业人员熟悉综合护理,但资源和时间的缺乏阻碍了他们在所在单位实施。

结论

对于重症监护和急诊专业人员而言,综合护理对其临床实践很重要,但实现综合护理仍存在障碍。了解综合护理对这些专业人员的重要性是在这些服务中制定实施措施的基础。这也是继续提供尊重患者尊严的人性化和富有同情心护理的动力。提供必要的基础设施和人力资源,以便使用这种方法照顾入住这些病房的患者是当务之急。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3a4/11989131/7220627cc4aa/healthcare-13-00745-g001.jpg

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