摘要
目的了解ICU临终患者家属临床决策的真实感受,为临床医护人在ICU临终患者治疗中提供有针对性的沟通.方法采用质性研究中的诠释现象学研究法,对12名ICU临终患者家属进行深入访谈,采用Van Manen分析法对访谈结果进行分析.结果经过反复的自省、比较、归纳,提炼出4大主题:ICU临终患者是否知晓病情并表达意愿是家属临床决策难的重要因素;道德及情感因素阻碍ICU临终患者家属的临床决策;经济状况困扰家属对ICU临终患者的临床决策;家属临床决策后表现出复杂的负性心理.结论在ICU临终患者家属中开展死亡教育,医护人员在适当时与患者沟通临终问题,使患者在清醒时表达自我意愿,以减轻临终患者家属的心理负担,让其作出最优化的临床决策方案,减少无效治疗,提高临终患者生存质量.
Objective To understand the true feelings of family members of ICU dying patients in clinical decision-making,and to provide targeted communication management for clinical doctors and nurses in the treatment of ICU dying patients.Methods Hermeneutic phenomenological research method in qualitative research was used to conduct in-depth interviews with the families of 12 ICU dying patients,and the interview results were analyzed by Van Manen analysis method.Results After repeated introspection,comparison and induction,four themes were extracted:whether ICU dying patients knew the condition and expressed their will was an important factor for family members'clinical decision-making;moral and emotional factors hindered the clinical decision-making of family members of dying patients in ICU;the economic situation puzzled the family members'clinical decision-making of ICU dying patients;family members showed complex negative psychology after clinical decision-making.Conclusion Death education should be carried out in the family members of ICU dying patients.Medical staff should communicate with patients about dying problems when appropriate,so that patients can express their will when they are awake,so as to reduce the psychological burden of the family members of dying patients,enable them to make optimal clinical decision-making plans,reduce ineffective treatment and improve the quality of life of dying patients.
出处
《浙江临床医学》
2022年第7期1073-1074,共2页
Zhejiang Clinical Medical Journal
基金
四川省教育厅课题(14SA0079)。
关键词
重症监护室
临终患者家属
临床决策
质性研究
ICU
Family members of dying patients
Clinical decision-making
Qualitative research
