外科ICU患者嫉囊属心理压力主要来源的质性研究.pdf

外科 ICU 患者家属心理压力主要来源的质性研究 李 丽1 ,赵继军2 ( 1.第二军医大学东方肝胆外科医院 麻醉科 ICU ,上海 200438; 2.第二军医大学长海医院 护理部,上海 200433) =摘要 目的 探讨 ICU 患者家属心理压力的主要来源。方法 采用半结构式访谈的方法,收集 12 名 ICU 患者家属心理压 力的主要来源,用质性研究内容分析法对资料进行分析。结果 外科 ICU 患者家属心理压力的主要来源包括: 担心患者救治 不成功(担心患者病情恶化/死亡、担心医护质量差、担心患者的远期预后不佳)、与医护人员的有效沟通不足以及经济压力。 结论 医护人员应重视医疗护理质量,努力提高 ICU 患者的抢救成功率;与家属做到有效沟通,及时向其介绍患者的病情、治 疗及检验结果,不良预后尽早告知, 主动联系和指导患者家属,建立家属的咨询电话; 另外, 逐步落实医保制度、倡导医疗社会 工作者制度、鼓励其亲友提供帮助等亦有助于缓解 ICU 患者家属的心理压力, 促进其生理与心理适应。 =关键词 压力; 主要来源;外科 ICU ;患者家属; 质性研究 =中图分类号 R395. 1 =文献标志码 A =文章编号 1008- 9993( 2011) 3B-0015-04 Qualitative Research on Main Stressors of PatientsFamilyMembers with Psychological Problems in Surgical ICU LI Li 1 , ZHAO J-i jun 2 ( 1. ICU of Department of Anesthesiolo gy, Eastern Hepatobiliary Surgery Hospital, Second M ilitary Medical Univer sity, Shanghai 200438, China; 2. Department of Nur sing , Changhai Hosp-i tal, Second M ilitary M edical U niversity , Shanghai 200433) Co rresponding autho r: ZHAO J-i jun, E-mail: zhaojijun2000@ yahoo . com =Abstract Objective T o explor e the main str essor s of the pat ients family member s w ith psycholog ical problems in surg ical ICU( SICU) . Methods By som-i str uctured inter view , 12 fam ily members of SICU pa- t ients w ere investig ated. The data w ere obtained and analyzed by means of contents analysis. Results The main st ressors of the SICU family member s of SICU pat ients included: w or ries due to unsuccessful rescue w ork( w orries about the deteriorat ion o f disease/ death, the low quality o f medical care and the poo r long- term outcome of the pat ient ) , shortage of g ood communicat ion w ith medical staff and the f inancial burden fo r rescuing the pat ient . Conclusion The medical staf f should attach more impor tance to improving the quality of medical and rescue success rate. Then, they should keep ef fect ive communication w ith the pat ient s family members to int roduce the pat ient s condit ions, t reatment , laboratory results and bad