Iqbal Naveeda, Safadi Reema, Bardaie Nafisa, Waheed Amir, Froelicher Erika S
Nursing, Al Shifa College of Nursing, Perinthalmanna, India
Nursing, Shifa College of Nursing & Midwifery, Islamabad, Pakistan.
BMJ Open. 2025 May 27;15(5):e092232. doi: 10.1136/bmjopen-2024-092232.
Proper positioning in trauma care is essential to prevent associated complications by stabilising haemodynamics, preserving the spine, securing the airway and protecting skin integrity. Motor vehicle crashes are the leading cause of traumatic brain injury (TBI) in Pakistan, necessitating rigorous safety measures and high-quality care due to their severe impact and high mortality rates. Resource-limited settings face significant challenges in providing adequate neurosurgical services. Moreover, there is a notable gap in the existing literature regarding effective care of patients with TBI. This study aims to address a gap in neurosurgical nursing research by exploring how nurses' interactions and behaviors during positioning interventions contribute to the cultural understanding of nursing care strategies and how the specific cultural context of the neurosurgical ward shapes and informs these interactions.
The current study will use a focused ethnography design. Patients with TBI, along with nurses and doctors, will be purposively selected from the neurosurgical wards of two tertiary care hospitals in Islamabad, Pakistan, based on set eligibility criteria. Data will be collected through participant observation, semistructured interviews and analysis of documents and artefacts to ensure diversity and trustworthiness. Braun and Clarke's Reflexive Thematic Analysis approach will be used for data analysis.
This study has been approved by the institutional review boards (IRBs) of Shifa Tameer-e-Millat University (IRB# 125-24) and the Pakistan Institute of Medical Sciences (No. f.1.1/215/ERB/SZABMU/1298). Potential ethical concerns will be addressed by protecting the rights of participants including avoiding harm, ensuring privacy and confidentiality and obtaining informed consent. In line with ethnography guidelines, this study adopted the process-informed consent to ensure informed and autonomous involvement. The study results will be shared with key stakeholders and published in scientific journals and presented at conferences.
在创伤护理中，正确的体位摆放对于通过稳定血流动力学、保护脊柱、确保气道安全和维护皮肤完整性来预防相关并发症至关重要。机动车碰撞是巴基斯坦创伤性脑损伤（TBI）的主要原因，鉴于其严重影响和高死亡率，需要采取严格的安全措施并提供高质量护理。资源有限的环境在提供足够的神经外科服务方面面临重大挑战。此外，现有文献在TBI患者的有效护理方面存在显著差距。本研究旨在通过探讨护士在体位干预期间的互动和行为如何促进对护理策略的文化理解，以及神经外科病房的特定文化背景如何塑造并影响这些互动，来填补神经外科护理研究的空白。
本研究将采用聚焦民族志设计。根据既定的纳入标准，从巴基斯坦伊斯兰堡的两家三级护理医院的神经外科病房中，有目的地选取TBI患者以及护士和医生。将通过参与观察、半结构化访谈以及对文件和人工制品的分析来收集数据，以确保数据的多样性和可信度。数据分析将采用布劳恩和克拉克的反思性主题分析方法。
本研究已获得希法塔米尔 - 伊 - 米拉德大学（IRB# 125 - 24）和巴基斯坦医学科学研究所（编号f.1.1/215/ERB/SZABMU/1298）的机构审查委员会（IRB）批准。将通过保护参与者的权利来解决潜在的伦理问题，包括避免伤害、确保隐私和保密以及获得知情同意。根据民族志指南，本研究采用过程知情同意，以确保知情和自主参与。研究结果将与关键利益相关者分享，并发表在科学期刊上以及在会议上展示。
