澳大利亚救护车服务护理人员响应后患者的非运输经验:一个建构主义的理论探索

Q2 Health Professions
Robbie King, F. Oprescu, B. Lord, B. Flanagan, T. Downer
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引用次数: 1

摘要

了解患者体验与质量、安全和有效的医疗保健相关。然而,缺乏解释患者如何经历非运输的知识,即个人接受计划外的救护车服务响应和护理人员主导的护理,从而决定不去医院急诊科(ED)。本研究项目旨在调查在澳大利亚救护车服务设置的非运输病人的经验。使用建构主义扎根理论方法,对21名参与者进行了深入的半结构化访谈,生成和分析数据,这些参与者在2020年8月至2021年10月期间接受了澳大利亚救护车服务的护理人员主导的医疗保健,导致无法运送。一个以“恢复自我效能”为中心的实质性理论产生了。它包括三个分类概念及其相互关联的关系,解释了患者如何经历非转运。“失去独立性”的概念是一个突发事件如何迫使患者意识到他们的环境脆弱性,激励他们采取行动寻求支持,从而导致救护车服务响应。“恢复自信”成为核心概念,是整体体验的中心,对患者做出不接受手术的决定有关键影响。当患者意识到他们从护理人员那里得到了专业、彻底和富有同情心的医疗服务时,他们会形成一种信任的伙伴关系,从而理解他们的情况不需要被送到急诊科。有了这种重建的观点,患者会表现出更强的“自我管理”能力,在护理后继续自己应对自己的情况。本文提供了一个理论模型来理解患者是如何经历非转运的。在管理感兴趣的健康话题时,经验受到与恢复自我效能相关的动态、复杂因素的影响。自我效能感的恢复受患者对其与医护人员互动的解释的影响。未来的研究可能会考虑调查将这些知识应用于护理人员教育和实践的影响,以及围绕非运输情况的质量指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patients’ experiences of non-conveyance following an Australian ambulance service paramedic response: A constructivist grounded theory exploration
Understanding patient experience is associated with quality, safe, and effective healthcare. However, there is a scarcity of knowledge explaining how patients experience non-conveyance, a setting where individuals receive unscheduled ambulance service response and paramedic-led care that results in a decision to not attend a hospital emergency department (ED). This research project aimed to investigate patients’ experiences of non-conveyance within an Australian ambulance service setting. Constructivist Grounded Theory methods were used to generate and analyse data from in-depth, semi-structured interviews with 21 participants who received paramedic-led healthcare from an Australian ambulance service between August 2020 and October 2021 that resulted in non-conveyance. A substantive theory centred on ‘Restoring self-efficacy’ was generated. It comprises three categorical concepts and their interconnected relationships, explaining how patients experience non-conveyance. ‘Losing independence’ conceptualises how a precipitating event forces patients to realise their circumstantial vulnerabilities, motivating action to seek support that leads to ambulance service response. ‘Restoring self-confidence’ emerged as the core concept, central to overall experience and a key influence on patients navigating the non-conveyance decision. When patients perceive that they have received professionally thorough and compassionate healthcare from paramedics, they form a trusting partnership resulting in the interpretation that their circumstances do not require conveyance to ED. With this reconstructed perspective, patients demonstrate increased ability for ‘Self-management’, by continuing to cope with their circumstances on their own after the episode of care. This paper provides a theoretical model for understanding how patients experience non-conveyance. Experience is influenced by dynamic, complex factors associated with restoring self-efficacy in relation to managing a health topic of interest. Restoration of self-efficacy was influenced by the patients’ interpretation of their interactions with paramedics. Future research may consider investigating the impacts of applying this knowledge to paramedic education and practice, and to quality indicators surrounding non-conveyance situations.
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来源期刊
Australasian Journal of Paramedicine
Australasian Journal of Paramedicine Health Professions-Emergency Medical Services
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发文量
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