ICU护理人文关怀障碍及促进因素的质性研究

doi:10.3761/j.issn.2096-7446.2024.05.004

摘要/Abstract

摘要： 目的了解ICU护士实践护理人文关怀的真实体验,分析其实践的障碍及促进因素,以期为提高护理人文关怀质量提供依据。方法采用目的抽样,于2023年3月—4月对长沙市3所三级甲等医院的23名ICU护士进行半结构访谈,应用能力、机会、动机、行为模型及主题分析法进行资料收集、整理和提炼主题。结果 ICU护士实践护理人文关怀受到能力、机会和动机三方面影响。能力方面,人文关怀素养、知识和技能不足是主要障碍;机会方面,工作强度高和人文循证实践不足,影响ICU护士人文关怀实践的条件和机会;动机方面,人文关怀意识和信心不足是主要障碍因素,而强烈的职业责任感、患者及家属的正向反馈、良好的团队合作氛围则是促进因素。结论推进ICU护理人文关怀过程中,需重视护士对人文关怀理念、知识和技能的培训需求,制订并实施人文关怀管理规范和评价制度,并创造支持人文关怀实践的组织氛围及环境,以期提升ICU护理人文关怀临床实践。

关键词: 重症监护病房, 危重病护理, 人文关怀, 能力、机会、动机、行为模型, 定性研究

Abstract: Objective To explore the experiences of ICU nurses in providing humanistic care for patients and to analyze the barriers and enablers of the practice,aiming to provide a basis for improving the humanistic care quality. Methods A purposive sampling method was used to select 23 ICU nurses from three tertiary Grade A hospitals in Changsha in March and April 2023 for semi-structured in-depth interviews. The data was collected and the themes were refined using abilities,opportunities,motivations,behavioral models,and thematic analysis method. Results The practice of humanistic care by ICU nurses was influenced by three aspects：capability,opportunity and motivation. In terms of capability,the primary barriers were deficiency in humanistic care literacy,knowledge and skills. In terms of opportunity,the high workload and limited implementation of evidence-based humanistic care affected the conditions and opportunities. In terms of motivation,the major constraints were the absence of awareness and the lack of confidence. However,a strong sense of professional responsibility,positive feedback from patients and families,and a good teamwork atmosphere were facilitating factors. Conclusion To promote the process of humanistic care in ICU,it is necessary to pay attention to the needs of nurses for humanistic care concepts,knowledge and skills,to develop and implement humanistic care management norms and evaluation systems,and to create an organizational atmosphere that supports humanistic care practice,so as to improve the clinical practice of humanistic care in ICU.

Key words: Intensive Care Units, Critical Care Nursing, Humanism, Capability,Opportunity and Motivation Behaviour Model, Qualitative Research

禹小燕, 王花芹, 唐莉, 潘思, 张丽, 李金秀. ICU护理人文关怀障碍及促进因素的质性研究[J]. 中华急危重症护理杂志, 2024, 5(5): 408-413.

YU Xiaoyan, WANG Huaqin, TANG Li, PAN Si, ZHANG Li, LI Jinxiu. The barriers and enablers to implementing humanistic care in ICU：A qualitative study[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(5): 408-413.

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