重症监护病房护士面对患者死亡情感体验的定性研究  

A qualitative study of emotional experience of facing patient death of nursesin intensive care units

作　　者：孙萌 岳鹏[1] 何茵[2] 王国艳 SUN Meng;YUE Peng;HE Yin;WANG Guoyan(School of Nursing,Capital Medical University,Beiing 100069,China;Bejjing Tongren Hospital of Capital Medical University,Beijing 100176,China)

机构地区：[1]首都医科大学护理学院,北京100069 [2]首都医科大学附属北京同仁医院,北京100176

出　　处：《中国心理卫生杂志》2024年第5期413-418,共6页Chinese Mental Health Journal

基　　金：国家社会科学基金项目(22BSH150)。

摘　　要：目的:了解重症监护病房(Intensive Care Unit,ICU)护士面对患者死亡的情感体验,探究存在替代性创伤反应的ICU护士面对患者死亡的情感体验。方法:本研究采用描述性现象学的研究设计,选取ICU存在替代性创伤反应(灾难救助者替代性创伤问卷各因子及总分超过理论中值)的责任护士16例,对其个体生活的参考框架、自我能力、自我资源、心理需求与认知图式和意象进行深入访谈,运用Colaizzi7步分析法进行资料分析。结果:ICU护士面对患者死亡的情感体验归纳为应激刺激下的自我防御和持续浸润后的情感内耗2个主题,其中应激刺激下的自我防御包括无意识的短暂封闭和个人化的情绪反应;持续浸润后的情绪内耗包括镜像复制患方情绪、尸体料理触发终结感、安慰家属束手无策、难以避免承担责任、消磨职业的归属感以及家庭成员关系严峻。结论:本研究总结了ICU护士面对患者死亡的双重情感体验,即应激刺激下的自我防御和持续浸润后的情感内耗。Objective:To understand the emotional experiences of Intensive Care Unit(ICU)nurses facing pa-tient deaths,particularly those exhibiting signs of vicarious trauma.Methods:Employing a descriptive phenomeno-logical research design,sixteen ICU nurses with signs of vicarious trauma(scores above the theoretical median on the Disaster Responders Vicarious Trauma Questionnaire)were selected for in-depth interviews.The interviews fo-cused on their reference frameworks,self-capacities,resources,psychological needs,cognitive schemas,and image-ry.Data were analyzed using Colaizzi′s seven-step methodology.Results:The emotional experiences of ICU nurses in the face of patient deaths were categorized into two themes,namely self-defense mechanisms under stress and e-motional exhaustion following prolonged exposure.The first theme includes unconscious temporary closures and personalized emotional reactions.The latter encompasses mirroring emotions of patients and their families,the sense of finality triggered by handling deceased bodies,feelings of helplessness in comforting families,unavoidable re-sponsibility,diminished sense of professional belonging,and strained family relationships.Conclusion:This study highlights the two-fold emotional impact on ICU nurses dealing with patient deaths,namely self-defense under stress and emotional exhaustion following prolonged immersion.

关 键 词：重症监护病房 护士 死亡 定性研究 

分 类 号：R192.6[医药卫生—卫生事业管理] R471[医药卫生—公共卫生与预防医学]