慢性伤口处理中的临床伦理困境探析——以1例产后脂肪液化合并线结反应的慢性伤口患者护理为例  

Ethical considerations of enterostomal therapists in dealing with the problems of patients with chronic wounds:taking a chronic wound patient with postpartum fat liquefaction combined with thread-knot reaction as an example

作　　者：夏振兰[1] 刘俊荣[2] 刘泽炫 陈丽萍[3] XIA Zhenlan;LIU Junrong;LIU Zexuan;CHEN Liping(Department of Surgery,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China;Institute of Humanities and Social Sciences,Guangzhou Medical University,Guangzhou 511436,China;Nursing Department,the Third Affiliated Hospital of Guangzhou Medical University Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院创伤外科,广东广州510150 [2]广州医科大学人文社会科学研究所,广东广州511436 [3]广州医科大学附属第三医院护理部,广东广州510150

出　　处：《中国医学伦理学》2024年第2期194-198,共5页Chinese Medical Ethics

基　　金：广东省护士协会面上项目立项“高龄老年人膀胱功能障碍的评估与术后尿潴留干预的护理研究”(gdshsxh2021a211);广东省教育厅课题立项“三全育人理念下临床护理师资精准教学体系培养的研究”(2021JD103)。

摘　　要：专科护士在临床中发挥越来越重要的作用,同时他们在独立面对患者时(尤其是造口治疗师/伤口造口专科护士)也常常为伦理难题所困扰。在前期构建的“临床护理伦理结构化分析表格”基础上,采用案例陈述法,以1例产后脂肪液化合并线结反应的慢性伤口患者的护理为例,分析造口治疗师在解决治疗冲突时的伦理思考。进而建议专科护士在解决患者疑难复杂问题时,需要充分考虑患者的意愿与背景特征,可采用“伦理分析四盒子模型”,以达到分析及解决伦理冲突问题的目的。Specialist nurses play an increasingly important role in clinical,and at the same time,they(especially enterostomal therapists/wound stoma specialist nurses)are often troubled by ethical problems when facing patients independently.Based on the“structured analysis form of clinical nursing ethics”constructed in the early stage,this paper used a case study method,took a chronic wound patient with postpartum fat liquefaction combined with thread-knot reaction as an example,conducted an in-depth analysis and reflection on the ethical problems of enterostomal therapists choosing treatment plans in clinical work,as well as proposed clinical recommendations.Base on this,this paper suggests that specialist nurses should fully consider the wishes and background characteristics of patients when nursing and treating patients,and use the four-box model of ethical analysis to analyze and solve ethical conflicts.

关 键 词：造口治疗师 护理伦理 临床伦理 专科护士 伦理冲突 

分 类 号：R-052[医药卫生]