养老机构失能老年人尊严照护体验及需求的质性研究

A qualitative study on the experience and needs of dignity-conserving care for the disabled elderly people in nursing homes

目的探讨养老机构中的失能老年人对尊严照护的体验及需求,旨在为构建该人群尊严照护质量评价体系和干预方案提供依据。方法采用描述性质性研究的方法,按照目的抽样法,于2022年8月—11月,选取杭州市某养老机构的13例失能老年人进行半结构式深入访谈,并以和谐护理理论为框架,采用定向内容分析法归纳和提炼主题。结果将失能老年人尊严照护的体验及需求提炼为5个主题:躯体安全(躯体健康维护、隐私保护、卫生与形象保持);心理健康(心理疏导、心理支持);社会交往(良好的交往环境、融洽的交往方式);精神文化(自我实现、尊重信仰);尊严照护需求(个性化健康需求、活动参与需求、尊严沟通需求、敬老精神需求)。结论养老机构护理人员在实施尊严照护时,应关注失能老年人躯体健康状况,维护失能老年人的隐私和形象,重视失能老年人心理健康,给予心理疏导和支持,加强无障碍环境及人文环境的建设,构建相互尊重的交往方式,促进失能老年人实现自我价值,拓宽失能老年人个性化服务与活动的参与渠道,强化养老机构尊严沟通与敬老精神建设,综合提升养老机构的尊严照护质量。

Objective This study aimed to explore the experience and needs of dignity-conserving care of disabled elderly people in nursing homes,and to provide a basis for formulating a quality evaluation system for dignity-conserving care.Methods This descriptive qualitative study,involving a semi-structured in-depth interview of 13 disabled elderly people based on purposive sampling,was conducted from August to November 2022 at a nursing home in Hangzhou.Based on the harmony nursing theory,the directional content analysis method was performed in order to summarize and extract themes from the interview texts.Results The dignity-conserving care experience and needs of disabled elderly people were extracted and classified into 5 themes,including physical safety(physical health maintenance,privacy protection,hygiene and image maintenance),psychological health(psychological counseling,psychological support),social communication(well communication environment,harmonious way of communication),spiritual culture(self-realization,respect for faith),needs of dignity-conserving care(individualized health needs,activity participation needs,dignified communication needs,spiritual needs of respecting the elderly).Conclusion When conducting the dignity-conserving care,nursing homes should pay attention to the physical health of the disabled elderly,actively maintain the image and privacy of the disabled elderly people,pay attention to the needs of psychological health,provide psychological counseling and support,strengthen the construction of barrier-free environments and cultural environments,build mutual respect way of communication,fully respect the religious beliefs of disabled elderly people,promote the realization of self-value of disabled elderly people,broaden the channels of personalized service and activity participation,strengthen the interaction of the dignity and spirit of the respect for the elderly of nursing homes,comprehensively improve the quality of dignity-conserving care in nursing homes.