以社区护士为主导的居家安宁疗护实践中叙事护理体验的质性研究  

A qualitative study on narrative nursing experience in home tranquility care practice led by community nurses

作　　者：魏秀娟 曹丽华 于华丽 刘玉玲 武芳芳 Wei Xiujuan;Cao Lihua;Yu Huali;Liu Yuling;Wu Fangfang(Beixiaguan Community Health Service Center in Haidian District,Beijing 100080,China;The Fifth Medical Center of the People’s Liberation Army General Hospital,Beijing 100000,China;Guangwai Community Health Service Center in Xicheng District,Beijing 100032,China)

机构地区：[1]北京市海淀区北下关社区卫生服务中心 [2]解放军总医院第五医学中心 [3]北京市西城区广外社区卫生服务中心

出　　处：《叙事医学》2024年第5期352-357,共6页Narrative Medicine

摘　　要：目的了解社区护士在运用叙事护理方法为居家患者实施安宁疗护过程中的工作体验和感受、个人成长收获以及职业发展需求,为探索社区居家安宁疗护模式和方法提供参考。方法采用描述性研究方法,以目的抽样法选取北下关社区卫生服务中心、广外社区卫生服务中心、蒲黄榆社区卫生服务中心、方庄社区卫生服务中心开展居家安宁疗护服务工作且由护士对患者实施叙事护理的社区卫生服务中心(站)的11名护士进行半结构式访谈。采用内容分析法进行整理、分析资料。结果在居家安宁疗护过程中开展叙事护理后,社区护士在工作体验和感受方面提炼出叙事护理模式认同感提升,职业价值感增强,拉近护患关系3个主题;在个人成长收获方面提炼出学会专业的心理护理方法,懂得尊重和关爱每个生命,共情能力提升,未来生活和工作赋能4个主题;在职业发展需求方面提炼出希望得到管理者的支持和相关政策支持2个主题。结论通过叙事护理在居家安宁疗护患者中的实施,社区护士职业认同感及自我价值感明显提升,居家安宁疗护能够更顺利地开展,同时改善了终末期患者的焦虑和抑郁状态,使其能够正向面对死亡。相关机构和管理者应给予社区护士支持,以提升其居家安宁疗护专业能力,为社区居家安宁疗护以及社区护理的发展提供保障。Objective To understand the nursing experience and feelings,personal growth gains,and career development support needs of community nurses in using narrative nursing methods to implement hospice care for home patients,and to provide a basis for exploring community home hospice care models and methods.Method Descriptive research method was used,and a purposive sampling method was used to select 11 nurses from Beixiaguan Community Health Service Center,Guangwai Community Health Service Center,Puhuangyu Community Health Service Center and Fangzhuang Community Health Service Center,4 community health service centers(stations)in Beijing that provide home based hospice care services.Nurses conducted semi-structured interviews with 11 nurses who provided narrative care to patients.Using content analysis method to organize and analyze data.Result After carrying out narrative nursing in the process of home-ba sed hospice care,community nurses extracted three themes in terms of work experience and feelings:increased identification with narrative nursing models,enhanced professional value,and closer nurse patient relationships;Extracting four themes in terms of personal growth gains:learning professional psychological care methods,understanding respect and care for every life,improving empathy and comfort abilities,and empowering future life and work;In terms of future career development needs,two themes have been extracted:hoping to receive support from managers and relevant policy support.Conclusion Through the implementation of narrative nursing in home based hospice care patients,community nurses have significantly improved their sense of professional identity and self-worth.Home based hospice care can be carried out more smoothly,improving the anxiety and depression status of end-stage patients,and enabling them to face death positively.Relevant institutions and managers should provide nurses with demand support to enhance their professional skills in home care and provide guarantees for the development of community ho

关 键 词：社区护理 安宁疗护 居家护理 叙事护理 护理体验 个人成长 质性研究 

分 类 号：R47[医药卫生—护理学]