Practical Experience in Home Care of Nursing Interns: A Qualitative Research

Purpose: To explore practical experience in home care of nursing interns. Methods: The phenomenological method for qualitative research was to interview 15 nursing interns in a semi-structured way, and then the collected data were analyzed and summarized by using the Colaizzi analysis method. Results: Interviewing results showed that there were five recurring themes, including: 1) personalized care;2) health education;3) humanistic care;4) solid professional foundation and sense of responsibility;5) expanded vision. Conclusion: Through home care practice, nursing interns deepened their cognitions of nursing connotation, stimulated their love for nursing and motivation of continuous learning, and improved their sense of identity to nursing career. In general, the practice of home care had a positive impact on nursing interns.

Research Progress of Humanistic Care Nursing

This paper summarizes the literature on the concept of humanistic care nursing, the research status of humanistic care nursing curriculum education and nursing practice at home and abroad, in order to provide reference and basis for humanistic care training and education.

Nursing undergraduates’experiences of a simulation-centred educational program in hospice care in Macao:A qualitative research

Objectives:The study aimed to explore the experiences of nursing undergraduates participating in a simulation-centred educational program in hospice care in Macao,China.Methods:This descriptive qualitative study was based on the data collected through semi-structured individual interviews.Seventeen nursing undergraduates in Macao,China who attended the simulation-centred program in hospice care participated in this qualitative from November to December 2020.This program included three parts:introduction to hospice care(2 h),management of terminal symptoms(10 h),and hospice situation simulations(6 h).The interview data were analyzed using qualitative content analysis.Results:This study revealed two themes and six sub-themes.Theme 1 was developing competencies in caring for dying patients and their families,which included four subcategories of sensitivity to patients’needs,knowledge of hospice care,skills of symptom control and comfort supply,and communication skills.Theme 2 was improving the ability to self-care and support colleagues,which included two subcategories of reflection on life and death and sharing and supporting among colleagues.Conclusion:This program improved the competency of nursing undergraduates in hospice care and participants’learning experience was good.

Health personnel's experience with resident-centered care in nursing homes in Korea: A qualitative study

Objectives: Changing the culture in nursing homes in South Korea comes with challenges,and the key issues of resident-centered care have been described.This study aims to describe health personnel's experience in providing resident-centered care in nursing homes.Methods: Qualitative data were collected through individual and focus group interviews consisting of registered nurses (n =4),certified nurse assistants (n =2),and long-term caregivers (n =12) working at nursing homes in South Korea.The participants (n-18) completed the interviews from May to June 2018,and all interviews were recorded,transcribed,and analyzed by employing the content analysis method.Results: Five main categories are conceptualized: (1) residents' participation in decision making,(2) the sharing of the history and story of residents,(3) the recognition of facility-or task-based attitudes,(4) the guarantee of private time and space for residents,and (5) the need for standardized guidelines.Conclusions: Results corroborate that health personnel regard resident-centered care as a desirable nursing paradigm.However,facility-or task-centered care is the most effective in hectic situations.A standardized protocol on the application of resident-centered care based on the facility-tailored specification is unavailable.Therefore,health personnel's perception and practice of resident-centered care can differ.Efficient nursing intervention programs should be developed after clarifying facility culture.

A qualitative study to explain the criteria of nursing managers in selecting effective nursing diagnosis

Objective:This study aimed to explain the criteria of managers at different levels of nursing in selecting effective nursing diagnosis.Methods:In conventional content analysis,10 nursing managers at different levels including head nurse,supervisor,and nursing manager were interviewed.Data was collected with semi-structured interviews and a narrative approach.Data analysis was performed using the Zhang–Wildemuth method simultaneously with sampling.Results:Four head nurses,four supervisors(educational,clinical),and two nursing managers were interviewed.The results of the a nalysis led to the extraction of two main categories:centrality of the nursing profession,with the sub-categories compatibility with nursing p ractices and compliance with organizational and professional principles of nursing,and covering the patient care aspect,with s ub-categories of having potential to facilitate and adapting to patient care conditions.Conclusions:The analysis of the views of nursing managers shows that health managers should consider various management aspects such as functional and organizational to increase the efficiency of nursing interventions in the selection of nursing diagnostic systems.From the point of view of health managers,nursing diagnoses should cover the considerations of patients,nurses,and work environments.

Barriers and facilitators to an outreach rehabilitation program delivered in nursing homes after hip fracture surgical repair

Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services;2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.

Qualitative Research and Narrative Sources in the Context of Critical and Renal Cares

The objective of this study is to clarify the relevance of qualitative research in the context of critical care and renal dialysis requires using narrative sources. Also specific objectives are to identify the phases or cultural moments that are distinguished in these processes. Research Question: How can the narrative materials contribute to the study of the processes of critical care and/or qualitative research in nephrology? Method and Sources: There have been studies focusing on the narrative of patients who have written their experiences building a literature experience ill (Siles et al., 1997, 1999, 2000). Sources have been used to extract testimony retrospective autobiographies written by people who have experienced the experiences of different diseases (Allué, 1996, 1997, Zorn, 1991, Gilbert, 1993;Comas, 2009;Gracia Armendáriz, 2010;Sampedro, 1996, Sacks, 2010). The analysis was developed by categorizing units of meaning, meaning families and networks. To identify the cultural moments we have followed the criteria established by Siles and Solano (2009): Multiculturalism, interculturalism and transculturalism. To identify rites of passage and liminality states have followed the principles outlined by Van Gennep (2013) and Turner (1990, 2008). Results: We identified cultural moments and characteristic states of liminality in critical care and kidney. Conclusions: narrative sources are effective for analyzing the meanings and experiences of patients in critical care and nephrology tool.

Unveiling the challenges encountered by newly graduated nurses during night shifts:A descriptive qualitative study

Objectives:Newly graduated nurses commence night shifts during a phase of heightened vulnerability to reality shock,exacerbating the challenges faced by these graduates.Therefore,this study aimed to identify the challenges experienced by newly graduated nurses when undertaking night shifts in order to help identify a strategy for supporting their adaptation to these shifts.Methods:Semi-structured personal interviews were used to collect data.Fifteen newly graduated nurses were selected to participate in the study by purposive sampling method from November 2021 to March 2022 in one of four general hospitals situated in the southwestern region of Japan.Semi-structured interviews were analyzed by using thematic analysis.Results:The analysis revealedfive central themes and nine subthemes:challenges in task efficiency(task organization challenges,challenges in time-constrained task performance),challenges in responding to patients’changing conditions(challenges in responding to patients’irregular conditions,challenges in responding to nighttime changes in patients’behaviors),challenges in independent practice(challenges in engaging in independent nursing practice,challenges in dealing with unexpected events),challenges in establishing collaborative relationships(challenges in working closely with other staff,challenges in establishing collaborative relationships during night shifts with limited resources),challenges in adapting to shift work(challenges in managing physical conditions for shift work).Conclusions:Newly graduated nurses often encounter challenges in performing their tasks during the transition period.When working night shifts,they face additional hurdles unique to nocturnal duties.Thefindings underscore the necessity for these graduates to develop night shift-specific readiness to effectively navigate the demands inherent in such work schedules.

Feeding tube self-management experience of patients at home after discharge following esophageal cancer surgery

BACKGROUND Esophageal cancer(EC)is an aggressive malignancy with low survival(10%-30%).Nutritional problems are present throughout the perioperative period and are key to prognosis.Home enteral nutrition appears to improve the nutritional status of patients with EC.Few studies have addressed the experience of patients administering their own nutritional fluids and managing their own feeding tubes at home.The aim of this study was to explore the real-life experience of self-management of feeding tubes in patients at home after EC surgery in the first 3 months after discharge following surgery.AIM To explore feeding tube self-management experience of patients at home 3 months after discharge following EC surgery.METHODS Face-to-face semi-structured interviews were conducted with 18 patients using a feeding tube at home after EC surgery.Thematic analysis of the recordings identified themes related to feeding tube self-management.RESULTS Patients expressed similar feelings about their tube management experiences concerning three contextualized themes:Self-management dilemmas,distressing experiences,and self-management facilitators.CONCLUSION There are many dilemmas and problems in self-managing feeding tubes in postoperative homebound patients with EC.Clinical staff should provide guidance to promote a positive change in self-management behavior.

Nurses’ Perceptions of Patient Safety in Community Mental Health Settings: A Qualitative Study

Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.

Theoretical framework construction on care complexity in Chinese hospitals: A grounded theory study

Objectives: This study aims to construct a theoretical framework to analyze risk factors and explore hospital nurses' perspectives on care complexity.Methods: The grounded theory method was adopted,and semi-structured in-depth interviews regarding the understanding of care complexity were conducted among the participants,including 31 nurses and nine doctors.In addition,data were coded and strictly analyzed in accordance with the coding strategy and requirements of grounded theory.Results: Our study reveals three factors that are closely related to care complexity,namely,(1) patient factors,including patients' condition,age,self-care abilities,compliance,social support systems,psy chological conditions,expectations,and requirements;(2) nursing staff factors,including work experiences,education,knowledge and operational skills of caring,and communication skills;and (3) organization and equipment factors,including nursing workforce,nursing workload,support from multidisciplinary teams and ancillary departments,and the conditions of medical and hospital services.Conclusions: This study defines care complexity on the basis of its factors.Care complexity refers to the difficulty of nursing tasks during patient care plan implementation,which are affected by patients,nurses,and other factors in nursing and multisectoral,multidisciplinary cooperation.The framework can be beneficial for nursing education and for the improvement of the quality and efficiency of clinical nursing practice.

心力衰竭患者居家安宁疗护期间照顾者照护体验的质性研究

目的调查心力衰竭患者居家安宁疗护期间照顾者的真实照护体验和需求,为缓解照顾者照护压力、提高照护能力、改善患者居家安宁疗护期间生活质量提供参考。方法选取心力衰竭患者居家安宁疗护期间的16名照顾者进行访谈,采用Colaizzi现象学分析法对访谈资料进行整理分析。结果心力衰竭患者居家安宁疗护期间照顾者照护体验可归纳为3个主题:选择安宁疗护后复杂情绪体验;角色适应不良与应对;渴望获得多方面支持。结论应采取多种措施给予照顾者专业和情感等方面支持,协助照顾者角色适应,提高心力衰竭患者居家安宁疗护期间的照护质量。

儿科门诊患儿家属护理人文关怀体验的质性研究

目的基于Cox健康行为互动模式理论,探索门诊患儿家属就诊过程中的护理关怀体验,为改善其就医体验提供参考。方法采用描述性质性研究方法,面对面访谈17名门诊患儿家属,运用内容分析法分析资料确定主题。结果门诊患儿家属的护理人文关怀体验共纳入4个主题11个亚主题,包括关怀独特性(个性化关怀、趣味关怀、空间关怀)、关怀互动性(专业水平、有效沟通、共情能力、健康信息)、关怀结局(有序就诊、高效便民)及关怀延续性(全流程关怀服务、“互联网+护理”延续服务)。结论儿科门诊患儿家属对护理的人文关怀体验总体较积极。应重视儿科门诊患儿的独特性,积极开展人文关怀实践,提高患儿及家属人文关怀的体验。

临床护士为终末期患者实施本土化叙事护理的体验

目的:了解临床护士结合中国传统文化为终末期患者实施叙事护理的体验,为本土化叙事护理的临床推广提供参考。方法:采用滚雪球抽样法,选取12名为终末期患者实施过叙事护理的临床护士进行半结构式访谈,采用主题分析法分析资料。结果:为终末期患者实施本土化叙事护理的过程中,临床护士的体验包括临床变革、实践历程、自我获益、困境与挑战4个主题。结论:通过对终末期患者实施本土化叙事护理,既缓解了临终患者的痛苦,也提升了护士的职业价值感,但叙事护理实践也面临着较多的挑战,需要来自管理层及组织层面的支持,以确保本土化叙事护理实践的可持续发展。

重症监护病房护士面对患者死亡情感体验的定性研究

目的:了解重症监护病房(Intensive Care Unit,ICU)护士面对患者死亡的情感体验,探究存在替代性创伤反应的ICU护士面对患者死亡的情感体验。方法:本研究采用描述性现象学的研究设计,选取ICU存在替代性创伤反应(灾难救助者替代性创伤问卷各因子及总分超过理论中值)的责任护士16例,对其个体生活的参考框架、自我能力、自我资源、心理需求与认知图式和意象进行深入访谈,运用Colaizzi7步分析法进行资料分析。结果:ICU护士面对患者死亡的情感体验归纳为应激刺激下的自我防御和持续浸润后的情感内耗2个主题,其中应激刺激下的自我防御包括无意识的短暂封闭和个人化的情绪反应;持续浸润后的情绪内耗包括镜像复制患方情绪、尸体料理触发终结感、安慰家属束手无策、难以避免承担责任、消磨职业的归属感以及家庭成员关系严峻。结论:本研究总结了ICU护士面对患者死亡的双重情感体验,即应激刺激下的自我防御和持续浸润后的情感内耗。

ICU护士经历护理缺失事件真实体验的质性研究

目的了解ICU护士经历护理缺失事件后的真实感受,以便有针对性地为其提供积极有效的应对措施。方法运用质性研究中的现象学研究法,对17名烟台市某三级甲等医院经历护理缺失事件的ICU护士进行半结构化访谈,采用内容分析法进行资料分析。结果17名经历护理缺失事件护士的真实体验可归纳为4个主题、15个亚主题。主题1:原因,人力资源、物力资源、患者因素、中断事件和ICU特殊性;主题2:应对,报告意愿低、逃避和反思;主题3:期待,完善制度、团队协作、期待理解和相关培训;主题4:认知,重视不足、认识不足和促进成长。结论临床工作中针对经历护理缺失事件的护士应采取相应措施消除相关影响因素;建议通过加强相关培训及心理干预,提高护士认知水平,促进其积极应对,以期避免护理缺失事件发生。

ICU医护人员临床警报管理体验及需求的质性研究

目的基于患者安全系统工程模型解析ICU医护人员临床警报管理的体验及需求,为制订临床警报管理相关策略提供参考依据。方法采用现象学研究方法,于2023年9月—11月,对温州市某三级甲等综合医院的12名ICU医护人员进行半结构式访谈,以患者安全系统工程模型为分析框架,采取Colaizzi 7步分析法进行资料分析、归纳及提炼主题。结果共提炼出警报管理不当对医患双方的不良影响、警报对工作任务的帮助与阻碍、警报与内外部环境的相互作用、组织层面开展警报管理的现状和困境、改进和优化警报系统的需求5个主题。结论临床警报管理受到多重因素的影响,临床上应通过监管警报相关不良事件,开展多元化培训教育,应用智能化工具和技术等手段,全方位提升警报管理的高效性和安全性,减轻ICU医护人员的工作负荷,切实保障患者安全。

安宁疗护护士道德困境体验质性研究的系统评价和Meta整合

目的系统评价安宁疗护护士道德困境体验。方法计算机检索PubMed、Web of Science、CINAHL、Embace、Cochrane Library、Scopus、中国知网、中国生物医学文献数据库、维普数据库及万方等数据库,收集与安宁疗护护士道德困境体验相关的质性研究,检索时限为建库至2024年3月。运用澳大利亚JBI循证卫生保健中心质性研究质量评价标准对纳入文献的质量进行评价。采用汇集性整合方法进行结果整合和归纳。结果共纳入11篇文献,提炼出38个研究结果,归纳为9个类别,得到3个整合结果:安宁疗护实践中的道德挑战;道德困境触发负性情绪;调整与应对。结论安宁疗护护士具有复杂的道德困境,需要护理管理者重视其困境体验并提供多样化支持,以改善安宁疗护护士工作中的道德困境。

肝癌行免疫治疗患者延续护理需求的质性研究

目的了解肝癌行免疫治疗患者延续护理需求,为临床制定延续照护策略提供参考。方法采用描述性质性研究,通过目的抽样法选取17例接受免疫治疗的肝癌患者进行半结构式深度访谈,并应用内容分析法进行资料分析和主题提炼。结果共提炼出4个主题和14个亚主题:缓解躯体不适需求(消化系统不适症状、皮肤不适症状、全身性不适症状和神经系统不适症状),健康生活方式指导需求(饮食指导需求、康复锻炼指导需求、睡眠促进需求和免疫疗法相关信息支持需求),社会心理支持需求(家庭支持需求、社会参与需求、情绪自我调适需求),社会资源支持需求(降低经济负担需求、社区卫生资源支持需求、多渠道延续照护需求)。结论肝癌免疫治疗患者延续护理服务需求较高,且需求呈现个体化及多样性特征。医护人员需重视患者症状管理,加强健康生活方式宣教,关注患者负性心理和社会参与度,结合患者延续护理需求构建并实施供需匹配的延续照护方案。

基于内容分析法的人性化健康教育中护理人员关怀行为探讨

目的探讨护理人员在健康教育中的人文关怀行为特征,为在健康教育中实践关怀行为提供参考。方法收集2023年12月1日至2024年4月30日的人性化健康教育事例1316篇,采用内容分析法归纳人性化健康教育过程中的关怀行为。结果人性化健康教育实施过程中的关怀行为可归纳为7个主题29个类目,分别为:识别健康教育需求、个性化评估、关怀性健康行为指导、提供关怀性环境支持、协调外部关怀性支持、反馈健康教育和延续关怀性健康教育。结论关怀行为在人性化健康教育中的表现形式多样,护理人员可参照关怀行为类目实施健康教育,以满足患者个性化健康教育需求。