加護病房護理人員所面臨的困境：以全人關懷照護器官移植者為例

The Dilemma of Critical Care Nurses Providing Holistic Care for Organ Transplant Patients

楊馥綺(Fu-Chi Yang) ； 施福忠(Fu-Jong Shih) ； 劉玉華(Yu-Hua Liu) ； 李佩佳(Pei-Cha Lee) ； 施富金(Fu-Jin Shih)

《嘉基護理》 12卷2期 (2012/12) Pp. 1-14

https://doi.org/10.29936/DMFCCHJN.201212.0001

摘要

加護病房護理人員對於全人關懷照護的觀念常感到疑惑；在器官移植者及其家屬身上落實此觀念時，常遇困境而產生無力感、失落感且難以調適的壓力。因此，本研究旨在探討加護病房護理人員提供器官移植患者及其家屬全人關懷照護時所面臨的困境。採探索性質性研究法，以某一家醫學中心為收案場所，以器官移植護理人員為研究對象，以半結構訪談指引，深入訪談收集資料，以質性內容分析法分析。30位受訪者參與本研究，研究顯示護理人員在照顧器官移植患者及其家屬時所面臨的困境有七項：（一）移植失敗的衝擊；（二）工作負擔過重；（三）醫師與護理人員欠缺良好溝通管道；（四）不安全的工作空間和擔心醫療糾紛；（五）感同身受患者之苦而不捨；（六）缺乏適當的心理支持；（七）缺乏專業的器官移植照護能力。本研究亦進一步針對困境提出建議，希望所有器官移植照護人員能接受有系統而完整的訓練計畫。另需建立工作人員諮商系統、與加強團隊溝通來建立共識，方能進而有效提升照護品質。

關鍵字

器官移植 ； 護理人員 ； 全人照護 ； 困境

並列摘要

Background: Nowadays, critical care nurses (CCNs) are challenged by providing holistic care for the organ transplant donors, recipients, and their families. The feelings of frustration, powerlessness, loss, and mal-adaptation are often heart.Purpose: This project attempted to explore CCNs' perceptions of the holistic care dilemma related to organ transplant (OT) clients and their families.Method: A qualitative exploratory study was employed. A purposive sample of CCNs with experiences of OT was obtained from a leading medical center in Central Taiwan. With a semi-structured interview guide, data were collected by in-depth face-to-face interviews, and analyzed by qualitative content analysis mode.Results: A total of 30 CCNs (29 females, 1 male) participated in this project. Seven types of caring difficulties were reported: (a) threat of transplant failure in difficult patients; (b) work overload; (c) insufficient collaboration of health team members due to lack of consensus and mutually respectful communication; (d) inadequate working space and worries about medical disputes; (e) stress of compassion with clients' suffering; (f) lack of adequate mental support; and (g) lack of professional caring competence.Conclusions: All OT health professionals are suggested to undergo systematic and comprehensive training programs. Additionally, establishing consulting system for OT nurses' adaptation, and effective communication among health team would also be needed in providing better holistic care for OT clients.

並列關鍵字

organ transplant ； critical care nurses ； holistic care ； dilemma