家屬面對病人入住加護病房之感受及照護需求

The Perceptions and Care Needs of Families of Patients in the Intensive Care Units

吳欣玫(HSIN-MEI WU)

指導教授 ： 吳秀麗

共同指導教授 ： 黃惠滿

長榮大學/健康科學學院/護理學系(所)/碩士(2016年)

摘要

本研究目的在瞭解家屬面對病人入住加護病房之感受與照護需求。研究過程採立意取樣並運用深度訪談方式，於2015年7月至2015年9月，在南部某區域教學醫院收集11位加護病房病人家屬的訪談資料。資料分析採主題分析法，並歸納出三個主題及13個次主題：（一）處理擔憂情緒的需求：害怕突如其來的訊息、擔心失去親人、擔心家人預後、不忍家人痛苦、面臨經濟問題、預期家庭角色重組的壓力及憂慮失去家庭支柱。（二）獲得病情資訊之需求：瞭解病情、獲得即時性的資訊。（三）確保家人照護品質之需求：藉觀察醫護人員的服務態度推測照護品質、由醫護人員解說推測照護品質、評估環境動態聯想照護品質及透過自行感受評價照護品質。由研究結果得知當病人入住加護病房時，護理人員能同理病人家屬的擔憂情緒、建立良好的溝通管道以協助家屬獲得病情資訊，並能確保病人的照護品質，是回應家屬感受及滿足家屬照護需求的最佳方式，本結果可作為加護病房護理人員提供家屬支持時之參考。

關鍵字

加護病房 ； 家屬 ； 照護需求 ； 感受 ； 質性研究

並列摘要

The purpose of this study was to investigate the perceptions and care needs of families of patients in the intensive care units (ICUs). This study was conducted using purposive sampling and in-depth interviews. Between July to September 2015, we collected interview data from the families of 11 patients in the ICU of a regional teaching hospital located in southern Taiwan. By employing thematic analysis for data analysis, the following three themes and 13 sub-themes were identified: (1) the needs to ease worries: fearing sudden notices; worrying about the possibility of losing the patients; being concerned of the prognosis of the patients; feeling unbearable to see the patients in pain; encountering financial problems; experiencing stress due to the anticipation of family role restructuring; and worrying about the possibility of losing the primary wage earner. (2) the needs to obtain information regarding patients condition: understanding patient’s condition; obtaining real-time information. (3) the needs to ensure the quality of care received by the patients: assessing the quality of care by observing the service attitude of health professionals; assessing the quality of care by listening to explanations provided by health professionals; assessing the quality of care by evaluating environmental dynamics; assessing the quality of care by evaluating one’s perceptions. The research results showed that when patients are admitted to ICUs, the optimal approaches for nurses to respond to the perceptions held by patient families and to satisfy the care needs of patient families are by empathizing with the worries of patient families, establishing effective communication channels to provide patient families with information regarding patient conditions, and ensuring the quality of patient care. The results of this study can serve as a reference for ICU nurses to provide support for patient families.

並列關鍵字

intensive care unit ； family ； care needs ； perceptions ； qualitative research

參考文獻

遠距健康照護服務之認知與需求調查研究—以心臟病、高血壓

療於緊急醫療之運用‧台灣醫學，15（2），151-156。

莊令史（2005）‧成人加護病房家屬不確定感及需求重要性之探討‧未

歐羽珊、康豑云、蔣立琦（2014）‧重症病人及家屬創傷後壓力症之照

宋雅雯、金繼春（2012）‧以家庭調整與適應反應模式照顧一個有疾病危