以质量求发展，以服务铸品牌

护理学报 ›› 2021, Vol. 28 ›› Issue (7): 43-48.doi: 10.16460/j.issn1008-9969.2021.07.043

• 循证护理 • 上一篇    下一篇

急诊科护士临终照护体验质性研究的Meta整合

李换则1, 陈鸿芳1,2, 黄丽群1, 安芳芳1, 徐鹏3, 庄苗青1, 张露语1, 王嘉懿1   

  1. 1.陕西中医药大学 护理学院,陕西 咸阳 712046;
    2.陕西省中医医院 护理部,陕西 西安 710003;
    3.青海大学 医学院,青海 西宁 810016
  • 收稿日期:2021-01-04 出版日期:2021-04-10 发布日期:2021-05-12
  • 通讯作者: 陈鸿芳（1972-）,女,陕西扶风人,硕士研究生,副主任护师,护理部主任,硕士研究生导师。 E-mail:13892881695@163.com
  • 作者简介:李换则（1994-）,女,陕西榆林人,本科学历,硕士研究生在读。
  • 基金资助:
    陕西省中医药管理局基金资助（2019-ZZ-ZC010）; 陕西中医药大学科研项目（2017rw03）

Qualitative Studies on Experience of Emergency Nurses in Hospice Care: A Meta-synthesis

LI Huan-ze1, CHEN Hong-fang1,2, HUANG Li-qun1, AN Fang-fang1, XU Peng3, ZHUANG Miao-qing1, ZHANG Lu-yu1, WANG Jia-yi1   

  1. 1. School of Nursing, Shaanxi University of Traditional Chinese Medicine, Xianyang 712046,China;
    2. Dept. of Nursing Administration, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi’an 710003,China;
    3. School of Medicine, Qinghai University, Xining 810016,China
  • Received:2021-01-04 Online:2021-04-10 Published:2021-05-12

PDF (PC)

92

赞

摘要： 目的 系统评价急诊科护士临终照护体验的质性研究,为国内急诊科临终照护发展提供循证依据。方法 计算机检索PubMed、CINAHL、PsycINFO、The Cochrane Library、Web of Science、中国知网、万方数据库和中国生物医学文献数据库,收集急诊科护士临终照护体验相关的质性研究,检索时限均为建库至2020年7月。采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准（2016）对纳入研究进行质量评价,并按照Meta整合的方法对结果进行整合。结果 共纳入8项研究,提炼32个结果,归纳成9个新的类别,综合成3个整合结果：（1）急诊科护士临终照护负性心理（情感负担、应对方式）;（2）急诊科护士临终照护正性心理（尽力满足患者需求、给予家属支持、职业满足感）;（3）急诊科临终照护障碍因素（教育、人力、环境、制度）。结论 护士自身和护理管理者应重视临终照护过程中产生的负性情绪,多途径提升急诊科护士情绪智力水平以及临终照护胜任力。同时,卫生部门应进一步支持急诊科临终照护的发展,提高急诊科临终照护质量。

关键词: 急诊科, 护士, 临终照护, 质性研究, 系统评价

Abstract: Objective To systematically evaluate the qualitative research on hospice care experience of nurses in emergency department, and to provide evidence-based basis for the development of hospice care in emergency department in China. Methods The PubMed, CINANL, PsycINFO, Cochrane Library, Web of Science, CNKI, Wanfang Data and CBM were searched for qualitative studies on experience of emergency nurses in hospice care from the inception to July 2020. The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of the eligible studies. The results were integrated by meta-synthesis method. Results Eight studies were incorporated, with 32 results being extracted and 9 new categories being summarized, which were finally integrated into 3 comprehensive results. (1) Negative psychology from hospice care of emergency nurses (emotional burden and coping style); (2) Positive psychology from hospice care of emergency nurses (trying to meet the needs of patients, giving support to family members and career satisfaction);(3)Barriers of hospice care in emergency department (education, manpower, environment, systems). Conclusion Nurses and nursing managers should pay attention to negative emotion in the process of hospice care, and try to improve emotional intelligence and hospice care competency of nurses in emergency department through multiple ways. Meanwhile, there should be more support for the development of hospice care, thus to improve the quality of hospice care in emergency department.

Key words: emergency department, nurse, hospice care, qualitative research, systematic review

中图分类号: 

  • R48
[1] Bailey C, Murphy R, Porock D.Trajectories of End-of-life Care in the Emergency Department[J]. Ann Emerg Med,2011,57(4):362-369.DOI:10.1016/j.annemergmed.2010.10.010.
[2] Beckstrand RL, Smith KE,Luthy KEB,et al.Rural Emergency Nurses’Suggestions for Improving End-of-life Care[J]. J Emerg Nurs,2017,43(3):214-220.DOI:10.1016/j.jen.2017.03.012.
[3] Gloss K.End of Life Care in Emergency Departments:A Review of the Literature[J].Emerg Nurse,2017,25(2):29-38.DOI:10.7748/en.2017.e1707.
[4] 徐秀萍,卢佳.急诊护士直面患者死亡时情绪体验的质性研究[J].当代护士(上旬刊),2019,26(12):6-9.
[5] 吕爱华. 患者死亡对急诊科护士心理影响的合众化研究[D].杭州:浙江中医药大学,2018.
[6] 徐旭东,金奕,赵媛,等.急诊科护士死亡态度与工作敬业度及组织公民行为的相关性研究[J].中国实用护理杂志,2019(29):2290-2294.DOI:10.3760/cma.j.issn.1672-7088.2019.29.010.
[7] 马明丹,陈珊珊,刘晓,等.死亡教育对急诊科护士的死亡态度和死亡焦虑的影响研究[J].中华护理教育, 2020,17(1):76-79.DOI:10.3761/j.issn.1672-9234.2020.01.016.
[8] 张小红,刘英,郭美英,等.基于目标教学理论急诊科护士死亡教育培训内容的构建[J].中华护理教育, 2020,17(10):914-918.DOI:10.3761/j.issn.1672-9234.2020.10.010.
[9] 丁传琦,金静芬.急诊科护士死亡态度对其临终照护态度影响的研究[J].中华护理教育,2020,17(3):275-278.DOI:10.3761/j.issn.1672-9234.2020.03.018.
[10] Keung JW, Hung MS, Pang SM.Emergency Nurses’ Perceptions of Providing End-of-life Care in a Hong Kong Emergency Department: A Qualitative Study[J]. J Emerg Nurs,2016,42(3):224-232. DOI:10.1016/j.jen.2015.10.025.
[11] Mughal A, Evans C.Views and Experiences of Nurses in Providing End-of-life Care to Patients in An ED Context: A Qualitative Systematic Review[J]. Emerg Med J,2020,37(5):265-272.DOI:10.1136/emermed-2018-208278.
[12] Walsh D, Downe S.Meta-Synthesis Method for Qualitative Research:A Literature Review[J]. J Adv Nurs,2005,50(2):204-211.DOI:10.1111/j.1365-2648.2005.03380.x.
[13] 胡雁,郝玉芳.循证护理学[M].北京:人民卫生出版社,2018:157-174.
[14] Lockwood C,Munn Z,Porritt K.Qualitative Research Synthesis:Methodological Guidance for Systematic Reviewers Utilizing Meta-aggregation[J]. Int J Evid Based Healthc,2015, 13(3):179-187.DOI:10.1097/XEB.0000000000000062.
[15] 袁浩斌. 循证护理中质性研究的Meta-整合方法[J].护理学杂志,2012,27(21):67-69.
[16] Wolf LA, Delao AM, Perhats C,et al.Exploring the Management of Death: Emergency Nurses’ Perceptions of Challenges and Facilitators in the Provision of End-of-life Care in the Emergency Department[J]. J Emerg Nurs, 2015,41(5):23-33. DOI:10.1016/j.jen.2015.05.018.
[17] Hogan KA, Fothergill-Bourbonnais F, Brajtman S, et al.When Someone Dies in the Emergency Department: Perspectives of Emergency Nurses[J]. J Emerg Nurs, 2016,42(3):207-212. DOI:10.1016/j.jen.2015.09.003.
[18] Bailey C, Murphy R, Porock D.Professional Tears: Developing Emotional Intelligence around Death and Dying in Emergency Work[J].J Clin Nurs, 2011, 20(23/24):3364-3372. DOI:10.1111/j.1365-2702.2011.03860.x.
[19] Giles TM, Hammad K, Breaden K, et al.Nurses’ Perceptions and Experiences of Caring for Patients Who Die in the Emergency Department Setting[J]. Int Emerg Nurs,2019,47:100789. DOI:10.1016/j.ienj.2019.100789.
[20] Decker K, Lee S,Morphet J.The Experiences of Emergency Nurses in Providing End-of-life Care to Patients in the Emergency Department[J].Australas Emerg Nurs J,2015,18(2):68-74. DOI:10.1016/j.aenj.2014.11.001.
[21] Kongsuwan W, Matchim Y, Nilmanat K,et al.Lived Experience of Caring for Dying Patients in Emergency Room[J].Int Nurs Rev,2016,63(1):132-138. DOI: 10.1111/inr.12234.
[22] 庞林薇,李晓莉,韩朋辉.急诊科护士对临终病人死亡事件真实体验的质性研究[J].全科护理, 2019,17(13):1623-1626.
[23] 魏薇萍,丁飙,王韬,等.急诊科护士情绪智力与人文关怀能力的相关性研究[J].护理管理杂志,2017,17(5):338-340.
[24] Mayer JD, Salovey P.What Is Emotional Intelligence?[M].New York:Basic Books,1997:3-31.
[25] Evans D,Allen H.Emotional Intelligence:Its Role in Training[J]. Nurs Times, 2002,98(27):41-42.
[26] Adriaenssens J, De Gucht V, Van Der Doef M, et al.Exploring the Burden of Emergency Care: Predictors of Stress-health Outcomes in Emergency Nurses[J]. J Adv Nurs,2011,67(6):1317-1328.DOI: 10.1111/j.1365-2648.2010.05599.x.
[27] Park KS, Yeom HA.Factors Influencing Korean Nurses’Attitudes towards Hospice Care[J]. Int Nurs Rev,2014,61(4):563-569.DOI:10.1111/inr.12135.
[28] 孙丽,许宝惠,顾道琴,等.国内外安宁疗护护士培训进展[J].护理学报, 2019, 26(19):27-30.DOI:10.16460/j.issn1008-9969.2019.19.027.
[1] 刘清玄, 张振香, 郭云飞, 张乐芸, 林蓓蕾, 梅永霞. 国内外脑卒中患者创伤后成长水平及其相关因素的系统评价[J]. 护理学报, 2021, 28(8): 1-7.
[2] 严露培, 姚丽丽, 赵庆华, 肖明朝, 李跃荣. 基于柯氏模型对TeamSTEPPS应用于医疗人员培训后效果维持的系统评价[J]. 护理学报, 2021, 28(8): 17-22.
[3] 任黎, 赵秀芳. 基于洋葱模型的妇幼专科医院新护士岗位胜任力模型及指标体系构建[J]. 护理学报, 2021, 28(7): 21-25.
[4] 刘萍, 尤奥林, 刘姝, 李亚楠, 栾晓嵘. 我国护理硕士专业学位研究生就读期间培养体验质性研究的Meta整合[J]. 护理学报, 2021, 28(7): 35-42.
[5] 郭一峰, 刘金榜, 郭爱敏, 韩伟, 高娜. 170名ICU倒夜班护士睡眠质量现状及影响因素分析[J]. 护理学报, 2021, 28(7): 59-63.
[6] 陈思羽. 老年医学科低年资护士对临终患者死亡事件体验的质性研究[J]. 护理学报, 2021, 28(7): 74-78.
[7] 李玉娟, 李君艳, 欧阳艳琼. 孕妇参与群组孕期保健体验质性研究的Meta整合[J]. 护理学报, 2021, 28(6): 6-12.
[8] 何怡庆, 周红, 高祖梅. 护士同情疲劳真实体验质性研究的Meta整合[J]. 护理学报, 2021, 28(6): 33-37.
[9] 易慧慧, 夏振兰, 李瑜, 黄海燕, 谭帧, 张丽华. 结构化膀胱管理预防老年髋部骨折患者术后尿潴留的效果研究[J]. 护理学报, 2021, 28(6): 65-70.
[10] 刘柳, 黄新, 邓丽君, 仝海英, 怡萍, 梁红霞, 张丹丹, 马艳艳. 西北地区2 704名本科学历护士个人职业规划现状及影响因素分析[J]. 护理学报, 2021, 28(5): 49-54.
[11] 郭晓宇, 王丽媛. 参与突发急性传染病护士救治体验的Meta整合[J]. 护理学报, 2021, 28(4): 43-49.
[12] 徐昌霞, 朱新宇, 孙志岭, 陈斌, 杨婷. 危害分析关键控制点体系在手术标本管理中的实证研究[J]. 护理学报, 2021, 28(3): 1-5.
[13] 李辉, 袁素娥, 陈佳星, 曾莉, 李云霞, 方静芝. 316名三级医院感染病科护士职业生涯现状及影响因素分析[J]. 护理学报, 2021, 28(3): 58-62.
[14] 贾莉莉, 张国增, 越丽霞, 朱康宁, 王志霞, 王飞杰. 临时性肠造口患者还纳术后居家生活体验的质性研究[J]. 护理学报, 2021, 28(2): 1-4.
[15] 刘晓黎, 吴晓舟, 李硕, 杨国艺, 王泠, 刘树佳. 基于岗位胜任力的护士长分层培训体系构建[J]. 护理学报, 2021, 28(2): 10-15.
Viewed
Full text


Abstract

Cited
  Shared   
[1] 杜金磊, 陈志美, 秦兰芳, 廉洁, 孙文静, 王翔, 徐巍, 邹晓月. 基于昼夜节律机制对ICU老年患者肠内营养延续性护理的对照研究[J]. 护理学报, 2021, 28(7): 1 -5 .
[2] 谭天, 庞永慧, 左红群, 邓玉燕. 隔姜灸对结直肠癌行腹腔镜根治术后凝血功能的影响[J]. 护理学报, 2021, 28(7): 6 -10 .
[3] 田丽, 李梦媛, 肖抒情, 阎玲. 晚期癌症患者预期性悲伤的现状及影响因素分析[J]. 护理学报, 2021, 28(7): 11 -14 .
[4] 管艳, 卢山, 叶家欣, 王哲芸. 心脏术后压力性损伤规范化实践方案的构建与应用[J]. 护理学报, 2021, 28(7): 15 -20 .
[5] 任黎, 赵秀芳. 基于洋葱模型的妇幼专科医院新护士岗位胜任力模型及指标体系构建[J]. 护理学报, 2021, 28(7): 21 -25 .
[6] 肖萍, 宋洁, 吴淑琳, 姜倩倩, 陈海雯, 刘霖. 护生接受痴呆教育干预的研究进展[J]. 护理学报, 2021, 28(7): 26 -29 .
[7] 刘雨安, 杨小文, 李乐之. 机器学习在疾病预测的应用研究进展[J]. 护理学报, 2021, 28(7): 30 -34 .
[8] 刘萍, 尤奥林, 刘姝, 李亚楠, 栾晓嵘. 我国护理硕士专业学位研究生就读期间培养体验质性研究的Meta整合[J]. 护理学报, 2021, 28(7): 35 -42 .
[9] 谢晓星, 赵敏慧. 229例产科监护室高危妊娠产妇泌乳启动延迟现状及影响因素分析[J]. 护理学报, 2021, 28(7): 49 -52 .
[10] 刘鑫, 江锦芳, 覃彦珠, 周帅, 施洁, 刘彦君. 215例结直肠癌造口患者家庭主要照顾者照顾能力现状及影响因素分析[J]. 护理学报, 2021, 28(7): 53 -58 .