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Intensive care nurses' experiences of providing end-of-life care after treatment withdrawal: a qualitative study.

机译:重症监护护士在戒断治疗后提供临终护理的经验:一项定性研究。

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摘要

Aim and objectives. To explore the experiences of intensive care nurses who provided end-of-life care to adult patients and their families after a decision had been taken to withdraw treatment.udBackground. End-of-life care following treatment withdrawal is a common phenomenon in intensive care. Less is known about nurses’ experiences of providing care for the dying patient and their family in this context, when compared to specialist palliative care.udDesign. Descriptive exploratory qualitative study.udMethods. A purposive sample of 13 intensive care nurses participated in a semi-structured face-to-face interview. Transcribed data was analysed using the principles of interpretative phenomenological analysis.udResults. The essence of nurses’ experiences of providing end-of-life care after the withdrawal of treatment was interpreted as doing the best to facilitate a comfortable and dignified death’. Four master themes included: caring for the dying patient and their family; providing and encouraging presence; reconnecting the patient and family; and dealing with emotions and ambiguity. Uncertainties were evident on processes and actions involved in treatment withdrawal, how to reconnect patients and their family effectively and how to reduce the technological environment.udConclusions. Providing end-of-life care after a decision has been taken to withdraw treatment was a common aspect of intensive care. It was evident that nurses were doing their utmost to support patients and families at the end of life, despite the multiple challenges they faced.udRelevance to clinical practice. The interpretive findings from this study should assist intensive care unit nurses to better understand and develop their role in providing high-quality end-of-life care after treatment withdrawal. Practice guidelines should be developed to reduce ambiguity and support the delivery of high-quality care for adults as they approach the final stages of life in intensive care units.
机译:目的和目标。为了探索重症监护室护士的经验,他们在决定撤回治疗后为成年患者及其家人提供临终护理。 ud背景。停药后的临终护理是重症监护中的常见现象。与专家姑息治疗相比,人们对护士在这种情况下为临终患者及其家人提供护理的经验知之甚少。 udDesign。描述性探索性定性研究。 udMethods。目的样本是13位重症监护护士参加的半结构式面对面访谈。转录数据使用解释性现象学分析原则进行分析。 ud结果。护士在戒断治疗后提供临终护理的经验的精髓被解释为尽力促进舒适和体面的死亡。”四个主要主题包括:照顾垂死的病人及其家人;提供和鼓励存在;重新与患者和家人建立联系;并处理情绪和歧义。在撤回治疗所涉及的过程和行动,如何有效地重新联系患者及其家人以及如何减少技术环境方面存在不确定性。 ud结论。在决定退出治疗后提供临终护理是重症监护的一个普遍方面。显然,尽管护士面临着多重挑战,但他们仍在尽最大努力为病人和家属提供生命的支持。 ud与临床实践有关。这项研究的解释性发现应有助于重症监护病房护士更好地理解和发展他们在停药后提供高质量的临终护理中的作用。应制定实践指南,以减少歧义,并在成人进入重症监护室的生命的最后阶段时为其提供高质量的护理。

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