重症监护室护士道德困境真实体验的质性研究

Qualitative Study on the Experiences of Moral Distress among Intensive Care Unit Nurses

描述重症监护室护士在患者临终过程中经历道德困扰体验及应对策略。采用现象学研究方法,对14名重症监护室护士进行一对一的半结构式访谈,采用Colaizzi现象学分析法对访谈资料进行编码、分类、解释及综合分析。重症监护室护士面临严峻的道德困境,有着无力感、冷漠及麻木等负性情绪,主要采取沉默、被动接受、自我调节等应对策略,缺乏有效的策略,管理层未给予充分的重视。今后应进一步深入了解护士的道德困境情况,对重症护理人员进行教育培训,制定减少道德困境的策略,以增强重症监护室护士的道德韧性。

To describe the experience and coping strategies of intensive care unit(ICU) nurses experiencing moral distress during the end-of-life care, 14 ICU nurses were semi-structured interviewed one-to-one by using phenomenological research method. Colaizzi phenomenological analysis method was used to encode, classify, interpret and comprehensively analyze the interview data. ICU nurses are faced with severe moral distress, with negative emotions such as powerlessness, apathy and numbness. Silence, passive acceptance and self-regulation are their usual coping strategies. nurses lack effective strategies and insufficient attention from the management. We should further understand the moral distress of nurses, conduct education and training projects, develop strategies to reduce moral distress, and enhance the moral resilience of ICU nurses.