护理人员照顾临终患者时的伦理困惑和应对方式  

Ethical dilemma and coping strategies of nurses involed in caring dying patients

作　　者：楼建华[1] 吴媚斯[2] 徐红[1] 朱海英[1] 

机构地区：[1]上海交通大学医学院附属儿童医学中心护理部,上海市200127 [2]上海交通大学医学院附属儿童医学中心肿瘤科,上海市200127

出　　处：《中华护理杂志》2010年第5期441-443,共3页Chinese Journal of Nursing

基　　金：上海市浦东新区社会发展局卫生科技项目(编号:PW2006D-1)

摘　　要：目的探讨临床护理人员照顾临终患者时所经历的伦理困惑和应对方式。方法运用现象学方法,对上海4个不同等级医院的25名护士进行深入访谈。结果护理人员遭遇的伦理困惑主要包括"减轻痛苦"与"延缓生命""生命价值"与"医疗资源不足""代理人行使知情同意权"与"医疗干预权"之间的不同立场和伦理决策取向。应对方式包括:耐心沟通并与患者家属达成共识;无力改变患者家属的决定,选择接受,自我调适;遵循规章制度,依赖团体决策等。结论本文对产生伦理困惑的原因进行了阐释和分析,对如何提高护理人员应对能力给出了建议,为临床护理伦理决策提供了参考和依据。Objective To explore nurses＇ experiences of ethics dilemma and coping strategies involed in caring dying patients.Methods Interviews were conducted with 25 nurses from four different levels of hospitals in Shanghai.Results The ethical dilemmas that participants encountered with were derived from different standpoint and ethics decision-making between ＂relieve pain＂ and ＂extend life span＂,＂life value＂ and ＂insufficient medical resources＂,＂agent execution for patients＇ rights of being informed consent＂ and＂medical intervention rights＂.Nurses＇ coping strategies included patiently communicating with family members to achieve agreement,failing to change family＇s decision then passively accepting it by self-adjustment,and following hospital rules and regulation or relying on team decision-making.Conclusion The study analyzed and discussed the reasons behind ethical dilemmas,as well as providing some suggestions on how to improve the coping abilities for nurse staffs.It can provide reference and basis for ethical decision-making.

关 键 词：临终医护 适应 心理学 护士 伦理困惑 

分 类 号：R48[医药卫生—临床医学]