实施干预措施的障碍和促进者,以减轻护士们的道德伤害
Cassandra M Godzik1,2, Jennifer K DiBenedetto1,2, Timothy J Usset3,4
1Department of Psychiatry, Dartmouth-Hitchcock Health System, Lebanon, NH, United States.
Frontiers in health services
|July 8, 2025
概括
在医疗保健中解决道德伤害至关重要. 这项研究确定了农村医疗重症监护病房护士实施干预措施的障碍和促进因素,强调了需要量身定制的支持和组织变革的需要.
科学领域:
- 实施科学 实施科学
- 医疗保健工作者 心理健康
- 这是道德上的伤害.
背景情况:
- 道德伤害很普遍,并影响医疗保健工作者 (HCW) 的心理和职业健康,特别是在流行病后.
- 医院对精神伤害的干预是有限的,并且让HCW参与心理健康支持是具有挑战性的,特别是在农村环境中.
- 了解障碍物和促进因素对于开发有效,可用和可接受的干预措施至关重要.
研究的目的:
- 识别农村医疗重症监护室 (MICU) 护士实施道德伤害干预措施的障碍和促进因素.
主要方法:
- 在农村医院系统中,对25名护士进行了半结构化的定性访谈 (19名现任MICU,6名前任MICU).
- 使用了实施科学研究的综合框架 (CFIR) 和社区参与的同行和学术模型.
- 采访被转录并使用专题分析进行分析.
主要成果:
- 五个CFIR领域和14个结构影响了干预实施.
- 障碍包括资源成本,怀疑,领导支持赤字,专业形象问题和缺少休息时间.
- 促进者包括量身定制的MICU干预,强有力的同行支持,由于高流动率的变化愿望,以及提供最佳护理的动机.
结论:
- 干预措施应通过单位特定的方法,同行支持和牧师来促进处理道德上有害的经历.
- 组织变革是必要的,以解决护士不断变化的需求,并改善支持系统.
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