在新生儿重症监护病房工作的护士中,影响新生儿不复苏命令的意识和态度的因素:混合方法研究
Jessie Shaji Paul1, Anu P, Surya Kant Tiwari
1Author Affiliations: Neonatal Intensive Care Unit, Neonatology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India (Mss Paul, Anu, Charlin, and Joshi); College of Nursing, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India (Mr Tiwari); Neonatology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India (Dr Verma); and College of Nursing, All India Institute of Medical Sciences, Kalyani, West Bengal, India (Dr Joshi).
大多数新生儿护士对不复苏 (DNR) 命令缺乏意识和积极态度,这影响了他们与家长讨论这些敏感话题的能力. 加强培训对于有效的沟通和支持至关重要.
科学领域:
- 新生儿重症监护室 (NICU) 护理科
- 医学伦理 医学伦理
- 医疗保健通讯 医疗保健通讯
背景情况:
- 在新生儿机构的终身护理决策中,不复苏 (DNR) 命令至关重要.
- 护士对DNR命令的理解和态度显著影响患者护理和家庭支持.
- 关于NICU护士对DNR命令的具体观点的研究有限.
研究的目的:
- 探索新生儿重症监护室 (NICU) 护士对"不复苏" (DNR) 命令的认识,态度和看法.
- 确定影响护士对DNR命令的意识和态度的因素.
- 了解护士在DNR讨论期间面临的情感挑战.
主要方法:
- 一个连续的混合方法研究,结合了定量调查和定性聚焦小组讨论.
- 对50名NICU护士进行了定量调查,以评估意识和态度.
- 与10名参与者进行定性访谈,以探索感知和情感经验.
主要成果:
- 超过一半的NICU护士表现出对DNR命令的认识不足 (52%) 和负面态度 (50%).
- 诸如未婚,不到5年NICU经验,不参加终身护理复习课程等因素与较低的意识和积极态度有关.
- 定性数据显示,护士在与家长讨论DNR命令时,会面临重大的情感挑战和缺乏能力的感觉.
结论:
- 在NICU护士对DNR命令的认识和积极态度方面存在很大的差距.
- 专注于同情心和有效沟通的全面培训计划对于NICU护士至关重要.
- 医院应该为护士提供持续的支持和咨询,为护士进行敏感的DNR讨论.
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