ICU护士对临终患者选择积极治疗认知的质性研究  

Qualitative research of ICU nurses' cognition on terminal-stage patients' selection of active treatment

作　　者：曹梅利[1] 祁智[1] 李丽[1] CAO Mei- li QI Zhi LI Li(East Department Hepatobiliary Surgery Hospital of The Second Military Medical University, Shanghai 201805)

机构地区：[1]第二军医大学东方肝胆外科医院重症医学科,上海市201805

出　　处：《护理实践与研究》2017年第1期11-13,共3页Nursing Practice and Research

基　　金：上海市卫计委青年面上项目(20154Y0174)

摘　　要：目的:了解ICU护士对临终患者选择积极治疗时内心真实想法及影响因素。方法:2015年1月~2016年5月研究者采用质性研究中现象学描述性定性研究方法,以深度访谈方式收集10名ICU护士的个案资料,并运用Colaizzi分析程序进行分析。结果:经过分析,共提取5个方面的主题:(1)病情与实际诊断的冲突。(2)病情告知权归属与护士认知的冲突。(3)医疗现状与现实合法化的冲突。(4)救治现状与传统观念的冲突。(5)患者权益与家属意愿方面的冲突。结论:临终患者选择积极治疗时ICU护士认为受到多种因素的影响,对于临终患者治疗方式应该确立标准、制定流程;应建立临终患者放弃治疗相关法律法规,健全临终患者放弃治疗标准;护理人员应加强自身专业知识学习和关于"生前预嘱""优死"的宣传教育,让更多的护士愿意加入到临终患者临床决策中去,更好地为临终患者及家属选择合理的治疗方式提供有效的指导意见或建议。Objective：To understand the cognition of ICU nurses on the real inner thoughts of terminal - stage patients when selecting active treatment and their influential factors. Methods：From January 2015 to May 2016, the researchers employed the phenomenological description qualitative research method in the qualitative research and collected the individual data of 10 ICU nurses in the form of deep interview, and applied Colaizzi analysis procedure for analy- sis. Results：Upon analysis, topics in 5 aspects were extracted：（ 1 ）Conflict between disease condition and actual diagnosis. （2）Belonging of right to inform disease condition and nurses＇ cognition. （3） Conflict between medical status and legalization of reality. （ 4 ） Conflict between the rescue status and tradi- tional concept. （5） Conflict between the patients＇ rights and interests and the family members＇ intention. Conclusion ： The ICU nurses thought that the ter- minal - stage patients＇ selection of active treatment was affected by many factors, and that for the treatment method of terminal - stage patients, it was re- quired to establish standards and procedures, and establish relevant laws and regulations for the terminal - staged patients to give up treatment and improve the standard for the terminal - staged patients to give up treatment; the nursing personnel should strengthen their learning of professional knowledge and the publicity education on ＂living will＂ and ＂superior death＂, so that more nurses would participate in the clinical decision of terminal - stage patients and se- lect reasonable treatment method or provide effective guideline or suggestions better for the terminal - stage patients and their family members.

关 键 词：临终患者 积极治疗 ICU护士 质性访谈 

分 类 号：R48[医药卫生—临床医学]