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限制护理的指令在Perianesthesia设置:一个Foucauldian案例研究报告报告
Joshua B Hardin1, Jeanne M Erickson2
1Department of Nursing, Inver Hills Community College, Inver Grove Heights, MN.
概括
成年患者的成年患者.
科学领域:
- 医学伦理 医学伦理
- 麻醉学 麻醉学
- 定性研究是指质量研究.
背景情况:
- 目前的指导方针要求在麻醉之前重新考虑不要复苏 (DNR) 命令.
- 然而,这些指令在周围麻醉环境中经常被暂停.
- 围绕这些限制的沟通没有得到充分的记录.
研究的目的:
- 探索关于成人患者在麻醉期间限制指令的复苏状态的决策过程.
- 了解患者,家庭和临床医生如何在这些讨论中进行导航.
- 调查关于周围麻醉中预先指示的沟通文献缺口.
主要方法:
- 采用福考尔德式后结构案例研究设计的定性调查.
- 通过采访和观察患者,家属和周围麻醉临床医生收集数据.
- 用于严格检查数据的上下文分析.
主要成果:
- 确定了影响患者和临床医生的选择的四种主要话语.
- 在周围麻醉文化中普遍存在的"我们只是暂停"话语导致指令暂停.
- 确定的障碍包括时间限制,不愿讨论预先指示和不清楚的责任.
- 患者难以翻译预先指示和权力动态的困难可能会阻碍尊重患者的选择.
结论:
- 即使有提前指令重新考虑的政策,患者的选择和决策机构也可能受到限制.
- 周围麻醉环境可能会限制患者遵守预先指示的能力.
- 需要进一步的研究来改善沟通和遵守患者的愿望.
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