eISSN 2097-6046
ISSN 2096-7446
CN 10-1655/R
Responsible Institution:China Association for Science and Technology
Sponsor:Chinese Nursing Association
Special Planning一Humanistic Nursing Care

The barriers and enablers to implementing humanistic care in ICU:A qualitative study

  • YU Xiaoyan ,
  • WANG Huaqin ,
  • TANG Li ,
  • PAN Si ,
  • ZHANG Li ,
  • LI Jinxiu
Expand
  • Critical Care Medicine Department,The Second Xiangya Hospital of Central South University,Changsha, 410011,China

Received date: 2023-10-12

  Online published: 2024-05-14

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.

Cite this article

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 . DOI: 10.3761/j.issn.2096-7446.2024.05.004

References

[1] Herridge MS,Azoulay É.Outcomes after Critical Illness[J]. N Engl J Med. 2023;388(10):913-924.
[2] Jones J,Winch S,Strube P,et al.Delivering compassionate care in intensive care units:nurses' perceptions of enablers and barriers[J]. J Adv Nurs,2016,72(12):3137-3146.
[3] Watson J.Human caring science:a theory of nursing[M]. 2nd ed. Boston,MA:Jones & Bartlett,2012:234-261.
[4] 吕亚兰. ICU护士人文关怀品质现状及其影响因素研究[D]. 开封:河南大学,2020.
LÜ YL.Study on the present situation and influencing factors of humanistic care quality of ICU nurses[D]. Kaifeng:Henan University,2020.
[5] 卜梦茹,翟惠敏,王映,等. 护理人文关怀示范病房建设规范的构建[J]. 中国护理管理,2021,21(7):1002-1008.
Bu MR,Zhai HM,Wang Y,et al.Standard development for constructing the humanistic nursing care demonstration ward[J]. Chin Nurs Manag,2021,21(7):1002-1008.
[6] Michie S,van Stralen MM,West R. The behaviour change wheel:a new method for characterising and designing behaviour change interventions[J]. Implement Sci,2011,6:42.
[7] Whittal A,Atkins L,Herber OR.What the guide does not tell You:reflections on and lessons learned from applying the COM-B behavior model for designing real life interventions[J]. Transl Behav Med,2021,11(5):1122-1126.
[8] Cane J,O'Connor D,Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research[J]. Implement Sci,2012,7:37.
[9] Kiger ME,Varpio L.Thematic analysis of qualitative data:AMEE Guide No. 131[J]. Med Teach,2020,42(8):846-854.
[10] Braun V,Clarke V.Using thematic analysis in psychology[J]. Qual Res Psychol,2006,3(2):77-101.
[11] Simpkin AL,Dinardo PB,Pine E,et al.Reconciling technology and humanistic care:lessons from the next generation of physicians[J]. Med Teach,2017,39(4):430-435.
[12] Alrabae YM,Aboshaiqah AE,Tumala RB,The association between self-reported workload and perceptions of patient safety culture:A study of intensive care unit nurses[J]. J Clin Nurs,2021,30:1003-1017.
[13] 中国生命关怀协会人文护理专业委员会. 医院护理人文关怀实践规范专家共识[J]. 中华医院管理杂志,2021,37(10):843-847.
Humanistic Nursing Professional Committee of China Association for Life Care. Expert consensus on standardized human caring practice in hospital nursing[J]. Chin J Hosp Adm,2021,14 37(10):843-847.
[14] 颜海萍,曾萍,陈红先,等. 体验式教学在ICU护士人文执业能力培养中的应用[J]. 医学与哲学,2022,43(1):53-56.
Yan HP,Zeng P,Chen HX,et al.The application of the experiential teaching method in the humanistic proficiency training for ICU nurse[J]. Med Philos,2022,43(1):53-56.
[15] Chatterjee S,Roberts B,Ahluwalia AK,et al.Integrating narrative goals of care in the medical intensive care unit:impact on educational and clinical outcomes[J]. ATS Scholar,2022,3(3):449-459.
[16] 付阿丹,张娟,朱聚,等. 体验式教学在新入职护士人文关怀培训中的应用[J]. 护理学杂志,2017(10):63-65.
Fu AD,Zhang J,Zhu J,et al.The use of experiential learning in cultivating caring ability of newly graduated nurses[J]. J Nurs Sci,2017(10):63-65.
[17] Brauchle M,Wildbahner T.The care of relatives and ICU teams during a crisis[J]. Med Klin Intensivmed Notfmed. 2020;115(2):114-119.
[18] 张可寅,翟祎帆,宋艳,等. ICU护士结构配置指标与护理结局质量指标相关性分析[J]. 中国卫生质量管理,2023,30(2):55-59.
Zhang KY,Zhai YF,Song Y,et al.Correlation analysis between structural allocation index among ICU nurses and nursing outcome quality index[J]. Chin Health Qual Manag,2023,30(2):55-59.
[19] De Boer M,Reimer-Kirkham S,Sawatzky R.How nurses' and physicians' emotions,psychosocial factors,and professional roles influence the end-of-life decision making process:an interpretive description study[J]. Intensive Crit Care Nurs,2022,71:103249.
[20] 许娟,莫蓓蓉,胡玉娜,等. 重症监护病房成人患者护理人文关怀专家共识[J]. 护理学杂志,2022,37(18):1-4.
Xu J,Mo BR,Hu YN,et al.Expert consensus on nursing human caring for ICU adult patients[J]. J Nurs Sci,2022,37(18):1-4.
[21] 中国生命关怀协会. 病区护理人文关怀管理规范[S].2022-04-08.
Chinese Association for Life Care. Management standards of nursing humanistic care in ward[S].2022-04-08.
[22] Davidson JE,Aslakson RA,Long AC,et al.Guidelines for family-centered care in the neonatal,pediatric,and adult ICU[J]. Crit Care Med,2017,45(1):103-128.
[23] 高翔,段晓侠. 基于诺丁斯关怀理论临床护士人文关怀能力评价指标体系的构建[J]. 蚌埠医学院学报,2022,47(1):102-109.
Gao X,Duan XX.Evaluation index system construction of humanistic caring ability for clinical nurses based on Noddings'caring theory[J]. J Bengbu Med Coll,2022,47(1):102-109.
[24] Zou DX,Xiong J,Huang SF,et al.Application effect of humanistic care time checklist on nursing quality of ICU patients[J]. Iran J Public Health,2023,52(4):741-746.
[25] Jakimowicz S,Perry L,Lewis J.An integrative review of supports,facilitators and barriers to patient-centred nursing in the intensive care unit[J]. J Clin Nurs,2017,26(23/24):4153-4171.
[26] 傅文瑶,庄一渝. ICU护士跨专业合作的影响因素及干预研究进展[J]. 中华急危重症护理杂志,2022,3(2):168-172.
Fu WY,Zhuang YY.Research on influencing factors and intervention of nurses'interprofessional collaboration in ICU[J]. Chin J Emerg Crit Care Nurs,2022,3(2):168-172.
Outlines

/