ICU护士照护长期昏迷患者真实体验的研究

Study on the real caring experience of intensive care unit nurses on patients with long-term coma

目的深入了解神经外科ICU护士照护长期昏迷患者的真实体验。方法采用现象学研究法,对11名神经外科ICU护士进行半结构式深入访谈,并用Colaizzi 7步法对访谈资料进行分析。结果神经外科ICU护士照护长期昏迷患者的真实体验共提炼出5个主题:形成多种情感体验(爱伤与共情共存;失望与希望交织)、领会职业素养必要性(慎独躬行,提高护理质量;视患犹亲,体现护理人文性)、感知重症思维重要性(批判性思维是应用专业知识的关键;病情预判为成功抢救提供有效保障)、获得自我价值认同感、审视血脉伦理与临床决策(坚持源于亲情血脉相连;放弃源自不忍生命质量低下)。结论神经外科ICU护士对照护长期昏迷患者的体验呈多维度,提示护理管理者应培养神经外科ICU护士职业素养、强化护士专业思维、提升护士自身价值、权衡血脉与伦理进行临床决策,进而为长期昏迷的神经重症患者提供更好的照护。

Objective To explore the real caring experience of nurses in neurological intensive care unit on long-term coma patients. Methods In the perspective of phenomenological approach,a total of 11 neurological intensive care unit nurses were enrolled for the semi-structured in-depth interviews and Colaizzi method was used to analyze the data. Results 5 themes were extracted,including forming multiple emotional experience(love and hurt coexisted with empathy;disappointment mingled with hope),understanding the necessity of professionalism(practicing carefully and improving the quality of nursing;regarding patients as the center and reflecting the humanistic nature of nursing),perceiving the importance of critical thinking(critical thinking is the key to apply professional knowledge;pre-judgement condition prediction provides effective guarantee for successful rescue),gaining a sense of self-identity,reviewing the relationship between ethics and clinical decision making(persisting because of kinship and family tie,giving up because of the poor quality of life). Conclusion The caring experience of neurological intensive care unit nurses on patients with long-term coma is multidimensional. Meanwhile,it is pointed out that the nursing supervisors should foster nurses’ professionalism,strengthen nurses’ professional mindset,increase nurses’ selfworth and enhance the ability of clinical decision-making based on the consideration of life and ethics,which could provide better care for the neurological patients with long-term coma.