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达累斯萨拉姆穆希姆比利国家医院重症监护病房护士与患者家属之间有效沟通的障碍:一项描述性定性研究。

Barriers to effective communication among nurses and family members of patients admitted to the intensive care unit at Muhimbili National Hospital in Dar es Salaam: A descriptive qualitative study.

作者信息

Ndile Menti Lastone, Charles Scholastica, Lukumay Gift

机构信息

Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Intensive Care Unit, Muhimbili National Hospital, Dar es Salaam, Tanzania.

出版信息

PLoS One. 2025 Sep 4;20(9):e0330374. doi: 10.1371/journal.pone.0330374. eCollection 2025.

Abstract

BACKGROUND

Effective communication in healthcare is essential for ensuring quality patient care. As healthcare shifts toward family-centered care, nurses are expected to engage families in information sharing and decision-making about their patients. However, barriers to effective communication in intensive care units (ICUs) exist. While global studies have addressed nurse-family communication, most are quantitative and conducted in contexts not similar to Tanzania. This study aimed to qualitatively explore the barriers nurses face in the Tanzanian context when communicating with family members in the ICUs at Muhimbili National Hospital, Dar es Salaam, Tanzania.

METHODS

A descriptive qualitative study was conducted using semi-structured interviews to explore communication barriers. Purposive sampling was used to select fifteen ICU nurses and twelve family members of ICU patients at Muhimbili National Hospital. All interviews were audio-recorded with consent and transcribed verbatim. Data were analyzed thematically following Braun and Clarke's six-phase framework.

RESULTS

The study identified two main themes emerging from the interviews: 1) Interpersonal barriers affecting the nurse-family relationship, and 2) Organizational barriers related to the work environment and resource limitations.

CONCLUSION

The study highlights that improving communication in ICU settings goes beyond individual efforts; it requires investment in staff training, adequate infrastructure, and a supportive organizational culture. Addressing both interpersonal and organizational barriers through targeted interventions can foster trust, enhance family satisfaction, and contribute to improved patient outcomes in critical care environments.

摘要

背景

医疗保健中的有效沟通对于确保优质的患者护理至关重要。随着医疗保健向以家庭为中心的护理转变,护士需要让患者家属参与有关患者的信息共享和决策。然而,重症监护病房(ICU)中存在有效沟通的障碍。虽然全球研究已经涉及护士与家属的沟通,但大多数研究是定量研究,且研究背景与坦桑尼亚不同。本研究旨在定性探索坦桑尼亚达累斯萨拉姆穆希姆比利国家医院ICU护士在与患者家属沟通时所面临的障碍。

方法

采用描述性定性研究,通过半结构化访谈来探索沟通障碍。采用目的抽样法选取了穆希姆比利国家医院的15名ICU护士和12名ICU患者的家属。所有访谈均在征得同意后进行录音,并逐字转录。数据按照布劳恩和克拉克的六阶段框架进行主题分析。

结果

该研究从访谈中确定了两个主要主题:1)影响护士与家属关系的人际障碍,以及2)与工作环境和资源限制相关的组织障碍。

结论

该研究强调,改善ICU环境中的沟通不仅仅需要个人努力;还需要对员工培训、充足的基础设施和支持性的组织文化进行投资。通过有针对性的干预措施解决人际和组织障碍,可以促进信任、提高家属满意度,并有助于改善重症监护环境中的患者预后。

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