基于叙事护理理论的ICU清醒患者人文关怀护理方案的构建  

Development of a humanistic care nursing plan for conscious patients in ICU based on narrative nursing theory

作　　者：金静怡 刘红梅[2] 许钦雯 张燕[2] 曹丹[2] 季建红[2] Jin Jingyi;Liu Hongmei;Xu Qinwen;Zhang Yan;Cao Dan;Ji Jianhong(School of Nursing and Rehabilitation,Nantong University,226001,Jiangsu Province,China;Department of Critical Care Medicine,Nantong First People’s Hospital,Nantong 226006,Jiangsu Province,China)

机构地区：[1]南通大学护理与康复学院,江苏南通226001 [2]南通市第一人民医院重症医学科,江苏南通226006

出　　处：《现代临床护理》2024年第10期57-65,共9页Modern Clinical Nursing

基　　金：南通市科技计划项目,项目编号为:MSZ2022094。

摘　　要：目的基于叙事护理理论,构建重症监护病房(intensive care unit,ICU)清醒患者人文关怀护理方案,为临床开展人文护理提供理论依据和实践指导。方法通过文献回顾和质性访谈了解国内外重症患者人文关怀现状及需求,以姜安丽和李春两位学者的叙事护理理论为基础,以护理程序为框架,经小组成员头脑风暴,构建ICU清醒患者人文关怀方案初稿。通过2轮德尔菲专家函询,根据专家意见对人文关怀方案条目进行修改。结果2轮问卷的有效回收率均为100.00%,专家权威系数为0.917,2轮函询条目重要性方面的Kendall协调系数W分别为0.331、0.421,可行性方面的Kendall协调系数W分别0.328、0.349,均P<0.001,条目内容重要性评分均数分别为3.43~5.00分、3.73~5.00分,变异系数分别为0~0.28、0~0.24,可行性评分的均数分别为3.30~5.00分、3.60~5.00分,变异系数分别为0~0.21、0~0.23。最终形成的人文关怀方案包含人文关怀实施前评估及准备、实施过程、效果评价等3个一级条目,共12个二级条目、31个三级条目。结论基于叙事护理理论构建的ICU清醒患者人文关怀护理方案经统计、分析、咨询结果可靠,操作性强,可行性佳,结果科学且实用。Objective To develop a humanistic care nursing plan for conscious patients in ICU based on narrative nursing theory and to provide a theoretical basis and practical guidance for clinical humanistic care.Methods Literature reviews and qualitative interviews were applied to examine the current situation and needs of humanistic care for critically ill patients at home and abroad.Based on the narrative nursing theory proposed by Jiang and Li,the first draft of humanistic care plan for ICU conscious patients was created based on care procedures by brainstorming among group members.The plan was finalised after two rounds of consultations with nursing specialists using Delphi’s method.Results Effective return rate was 100%from both rounds of questionnaires.The expert authority coefficient was 0.917,the Kendall’s coefficient of concordance W for the importance of items in the two rounds of inquiries were 0.331 and 0.421,respectively,and the Kendall’s coefficient of concordance W for feasibility were 0.328 and 0.349,respectively(P<0.001).The mean scores for the importance of item content were 3.43 to 5.00,and 3.73 to 5.00,with coefficients of variation from 0 to 0.28 and 0 to 0.24,respectively.The mean scores for feasibility were 3.30 to 5.00,and 3.60 to 5.00,with coefficients of variation from 0 to 0.21 and 0 to 0.23,respectively.The finalised humanistic care plan included three first-level items:pre-implementation assessment and preparation,implementation process,and effectiveness evaluation,with a total of 12 secondary items and 31 tertiary items.Conclusion After statistical analysis,it is found that based on narrative nursing theory,the humanistic care nursing plan for conscious patients in ICU developed in this study,is reliable,highly operational,feasible,scientifically sound and practical.

关 键 词：叙事护理 ICU清醒患者 人文关怀方案 德尔菲 

分 类 号：R47[医药卫生—护理学]