医护人员对腰椎间盘突出症中医护理体验的质性研究

A qualitative research on medical staff’s experience of traditional Chinese medical nursing program for lumbar disc herniation

目的探讨腰椎间盘突出症中医护理方案临床实施后医护人员的体验,为腰椎间盘突出症中医护理方案优化提供参考依据。方法采用目的抽样法,选取杭州市6家三级甲等中医医院及中西医结合医院熟悉腰椎间盘突出症中医护理方案的14名骨科及针灸推拿科护士长、中医护理骨干、高年资中医师进行深入访谈。运用Colaizzi分析法分析、提炼主题。结果方案实施过程中,医护人员呈现正性和负性两种体验。正性体验主要是护士普遍认为该方案对腰椎间盘突出症临床护理指导意义重大,可提升中医护理能力以及提高疾病的关注度;负性体验包括辨证施护存在困惑、技术选择有不确定感、具体实施存在困难、技术应用有利益关系,以及统计评价带来护士的排斥。结论需要进一步总结优化中医护理方案,提高其临床应用可操作性,简化统计流程,提高效果评价科学性,提升临床护士的中医护理能力并得到医生的配合,从而更好地落实腰椎间盘突出症中医护理方案。

Objective To explore the experience of medical staff after the clinical implementation of traditional Chinese medical(TCM)nursing program for lumbar disc herniation,and to provide reference for the optimization of the TCM nursing program.Methods A purposive sampling method was used to select 14 nurse leaders,TCM nursing cadres and senior TCM practitioners from orthopaedic and acupuncture and massage departments familiar with TCM nursing for lumbar disc herniation in six tertiary-level A Chinese medicine and combined Chinese and Western medicine hospitals in Hangzhou for in-depth interviews.The themes were analyzed and refined using Colaizzi analysis.Results During the implementation of the program,health care workers presented both positive and negative experiences.The positive experiences were mainly that the nurses generally felt that the program was significant in guiding clinical care for lumbar disc herniation,enhancing TCM nursing competence and increasing disease concern;the negative experiences included confusion in evidence-based care,uncertainty in technique selection,difficulties in specific implementation,interest in technique application,and rejection by nurses due to statistical evaluation.Conclusion There is a need to further summarize and optimize the TCM nursing protocol,improve the operability of its clinical application,simplify the statistical process,improve the scientific nature of effect evaluation,and enhance the TCM nursing competence of clinical nurses and the cooperation of doctors,so as to better implement the TCM nursing protocol for lumbar intervertebral disc herniation.