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

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.
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