重症监护室护士道德困境体验质性研究的Meta整合  

Meta-synthesis of qualitative studies on moral dilemma experience in ICU nurses

作　　者：许金玲 曾莉[2] 姜金霞[1] 杜云海[1] Xu Jinling;Zeng Li;Jiang Jinxia;Du Yunhai(Department of Emergency,The 10th People′s Hospital Affiliated to Tongji University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院急诊科,上海200072 [2]同济大学附属同济医院护理部

出　　处：《护理学杂志》2024年第14期59-64,共6页Journal of Nursing Science

基　　金：国家自然科学基金项目(72004162);上海市医务工会重点课题(2023YGL07);医企融合创新支撑技能培训专项(SHDC2023CRS002)。

摘　　要：目的了解重症监护室护士道德困境的真实体验,为管理者制定干预措施,提高重症监护室护士幸福感,稳定护理队伍提供参考。方法检索中国知网、维普、中国生物医学文献数据库、万方、PubMed、the Cochrane Library、Web of Science、Embase数据库关于重症监护室护士道德困境的质性研究,检索时限为建库至2023年7月24日。根据JBI循证卫生保健中心推荐的质性研究质量评价标准对纳入文献进行质量评价,运用Meta整合方法对研究结果进行整合。结果共纳入8篇文献,从纳入研究中提炼出36个主题,将其归纳成为10个新类别,综合成3个整合结果,即ICU护士经历道德困境受多种因素影响,护士遭遇道德困境时的情感体验,应对道德困境的策略。结论重症监护室护士存在一定程度的道德困境,护理管理者应了解其产生的原因,并制定和实施有效干预措施,以减少重症监护室护士道德困扰,促进护士生理心理健康发展,稳定护理队伍。Objective To understand the real experience of moral dilemmas in ICU nurses,so as to provide references for managers developing interventions to improve the well-being of ICU nurses and stabilize the nursing workforce.Methods Qualitative studies on moral dilemma experience in ICU nurses were retrieved from databases,including CNKI,VIP,SinoMed,Wanfang,PubMed,the Cochrane Library,Web of Science,and Embase,the search time frame was from database inception to July 24th,2023.The quality of the included literature was assessed based on the qualitative research quality evaluation criteria recommended by the Joanna Briggs Institution(JBI).Meta-synthesis method was applied to synthesize the research findings.Results A total of 8 articles were included,with 36 themes being extracted and categorized into 10 new categories and further synthesized into three integrated results:moral dilemma experienced by ICU nurses affected by multiple factors,emotional experience when nurses encounter moral dilemma,and strategies coping with moral dilemma.Conclusion ICU nurses experience moral dilemma.Nursing managers should understand its causes,then develop and implement effective intervention to alleviate ICU nurses′moral dilemma,promote their physical and mental health development,and stabilize the nursing workforce.

关 键 词：护士 重症监护室 道德困境 道德决策 道德冲突 情感体验 应对策略 Meta整合 

分 类 号：R47[医药卫生—护理学] R192.6[医药卫生—临床医学]