ISSN 2096-7446 CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会

中华急危重症护理杂志 ›› 2023, Vol. 4 ›› Issue (11): 973-977.doi: 10.3761/j.issn.2096-7446.2023.11.002

• 论著 • 上一篇    下一篇

机械通气患者家属替代决策困境体验的质性研究

唐莉 禹小燕 王花芹 李金秀   

  • 出版日期:2023-11-10 发布日期:2023-11-24

Qualitative research on experience of the dilemma of surrogate decision-making among mechanical ventilation patients’ family members

TANG Li,YU Xiaoyan,WANG Huaqin,LI Jinxiu   

  • Online:2023-11-10 Published:2023-11-24

摘要: 目的 探讨机械通气患者家属替代决策困境体验,为提升替代决策者的决策质量 和满意度提供参考。 方法 2020年5月-2020年10月,对长沙市某三级甲等医院ICU所收治机械通气患者的替代决策家属进行半结构访谈,以Colaizzi现象学分析法对访谈资料进行编码、分类、解释及分析。 结果 分析得出以下三大主题院决策行为类型多样、决策内心活动复杂、决策挑战多维化。 结论 需关注和识别机械通气患者家属作为替代决策者的困境和需求,增进医护人员与替代决策者之间的沟通和信任,优化家属参与医疗决策的心理支持及应对策略,提升替代决策者的决策能力和满意度。

关键词: 重症监护病房, 机械通气, 替代决策, 质性研究, 危重病护理

Abstract: Objective To explore the experiences of surrogate decision-making dilemma among mechanically ventilated patients’ family members,and to provide a guidance for improving the decision quality and satisfaction of proxy decision-makers. Methods From May 2020 to October 2020,semi-structured interviews were conducted with family surrogate decision-makers of mechanically ventilated patients in ICU of a tertiary care hospital in Hunan Province. The interview data were coded,categorized,interpreted,and analyzed by Colaizzi phenomenological analysis. Results The following three themes are obtained from the analysis: diverse types of decision-making behavior,com- plex inner activities of decision-making, multi-dimensional decision-making challenges. Conclusion It is necessary to pay attention to and identify the dilemmas and needs of family surrogate decision-makers for mechanically venti- lated patients,enhance communication and trust between medical staff and surrogate decision-makers,and optimize psychological support and coping strategies for family surrogate decision-makers,so as to improve the decision-mak- ing ability and satisfaction of surrogate decision-makers.

Key words: Intensive Care Units, Mechanical Ventilated, Surrogate Decision-Making, Qualitative Research, Critical Care Nursing