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重症监护中生命维持治疗撤除前和撤除时以家庭为中心的护理:澳大利亚重症监护的护理人员与患者家属分享信息的调研

Kristen Ranse Melissa Bloomer Maureen Coombs Ruth Endacott   

  1. 澳大利亚堪培拉大学健康学院护理与助产科(Kristen Ranse);澳大利亚吉郎市迪肯大学护士和助产学校生命质量和患者安全研究中心(Melissa Bloomer);新西兰惠灵顿市维多利亚大学护理助产学和健康研究生院,新西兰惠灵顿市惠灵顿地区医院首都和海岸区卫生局(Maureen Coombs);澳大利亚弗兰克斯顿市莫纳什大学护士和助产学校半岛校园,英国德文郡普利茅斯市普利茅斯大学护士和助产学校(Ruth Endacott)
  • 出版日期:2017-06-25 发布日期:2017-06-25

Family centred care before and during life-sustaining treatment withdrawal in intensive care: a survey of information provided to families by Australasian critical care nurses

  • Online:2017-06-25 Published:2017-06-25

摘要: 背景:重症监护室为患者提供临终关怀时,以家庭为中心的护理的核心要素是与家属的信息共享。但对在这种环境下共享的信息仍知之甚少。目的:在生命维持治疗准备撤除和撤除时,确认重症监护室护理人员最常提供给患者家属的信息。方法:2015年5月,澳大利亚和新西兰的重症监护室护理人员受邀完成“治疗撤除的家庭准备”问卷。数据分析包括进行描述性统计,以确定最常和最少与家属分享的信息面。人口学统计资料的交叉列表用于探测数据的相关性。结果:159名重症监护室护理人员的回答显示,在生命维持治疗准备撤除和撤除时,最常与家属分享的是家庭的情感关怀和支持的相关信息。死亡过程中,患者身体状况及相关的生理改变等信息提供的频率,存在较大变异。人口学变量(性别、护理经验和重症护理经验)与某些最常和最少分享信息之间存在相关性(P<0.05)。结论:临终关怀期间,由重症监护室护理人员给予的信息分享反映了以家庭为中心的护理方法,涉及关于家庭的情感关怀和支持等至关重要的信息。本研究的发现,为此时发展干预措施,以改善实践和支持护理人员与患者家属沟通交流,提供了一个有用的框架。

Abstract: Background: A core component of family-centred nursing care during the provision of end-of-life care in intensive care settings is information sharing with families. Yet little is known about information provided in these circumstances. Objective: To identify information most frequently given by critical care nurses to families in preparation for and during withdrawal of life-sustaining treatment. Methods: During May 2015, critical care nurses in Australia and New Zealand were invited to complete the Preparing Families for Treatment Withdrawal questionnaire. Data analysis included descriptive statistics to identify areas of information most and least frequently shared with families. Cross tabulations with demographic data were used to explore any associations in the data. Results: From the responses of 159 critical care nurses, information related to the emotional care and support of the family was most frequently provided to families in preparation for and during withdrawal of life-sustaining treatment. Variation was noted in the frequency of provision of information across body systems and their associated physical changes during the dying process. Significant associations (P<0.05) were identified between the variables gender, nursing experience and critical care experiences and some of the information items most and least frequently provided. Conclusion: The provision of information during end-of-life care reflects a family-centred care approach by critical care nurses with information pertaining to emotional care and support of the family paramount. The findings of this study provide a useful framework for the development of interventions to improve practice and support nurses in communicating with families at this time.