神经外科重症监护病房患者家属真实心理体验的质性研究

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目的:深入了解神经外科重症监护病房患者家属在陪护期间的真实体验,为管理者制订护理对策提高家属的应对能力提供参考依据。方法:采用质性研究中描述性现象学研究法,对12例上海市第十人民医院神经外科重症监护病房住院的患者家属进行深入访谈,借助Nvivo11软件管理访谈资料,采用Colaizzi七步分析法进行归纳分析并提炼主题。结果:产生4个主题:坚守与不放弃,坚守是缘于对医护的信任与肯定、不放弃是因难以割舍血脉亲情、坚持是因病友点亮生的希望;情感体验的时机性变化,急救期:对抢救无措和期待病情稳下来,并发症高峰期:理解疾病特点和关注治疗进展,稳定期:对预后不确定和渴望情感陪护;面对未来的无力感;学会自我心理调适。结论:神经外科重症监护病房患者家属消极体验和积极感受并存,在疾病不同阶段的陪护体验和需求呈动态变化,根据患者家属认知和需求,探索发展姑息医学,从积极的视角挖掘家属潜能提升应对能力,是维持家属稳定心理健康状态的途径之一。“,”Objective:To deeply understand the real experience of family members of patients in the neurosurgery intensive care unit during the period of accompanying them, and to provide reference for managers to formulate nursing countermeasures to improve the coping ability of family members.Methods:Descriptive phenomenological research method in qualitative research was adopted to conduct in-depth interviews with family members of 12 patients admitted to a neurosurgery intensive care unit in Shanghai, manage the interview data with Nvivo11 software, and use Colaizzi's seven-step analysis method to summarize and analyze the topic.Results:There were four themes: adhere to and do not give up, adhere to was due to the trust and affirmation of the medical care, do not give up was because it was difficult to give up blood kinship, adhere to the hope of life because of patients; timing change of emotional experience, first aid period: helpless to rescue and expecting the condition to stabilize, complication peak: understanding the characteristics of the disease and paying attention to the treatment progress, stable period: uncertain prognosis and desire for emotional companionship.The powerlessness of the future; learn to self psychological adjustment.Conclusions:The family members of patients with severe neurological diseases have both negative experience and positive feelings, and the accompanying experience and needs at different stages of the disease are changing dynamically. According to the cognition and needs of the family members, exploring and developing palliative medicine, tapping the potential of the family members from a positive perspective and improving coping ability are one of the ways to maintain the stable mental health of the family members.
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