PDF(Pubmed)
Abstract：
Triggers have been developed internationally to identify intensive care patients with palliative care needs. Due to their work, nurses are close to the patient and their perspective should therefore be included. In this study, potential triggers were first identified and then a questionnaire was developed to analyse their acceptance among German intensive care nurses.
For the qualitative part of this mixed methods study, focus groups were conducted with intensive care nurses from different disciplines (surgery, neurosurgery, internal medicine), which were selected by convenience. Data were analysed using the \"content-structuring content analysis\" according to Kuckartz. For the quantitative study part, the thus identified triggers formed the basis for questionnaire items. The questionnaire was tested for comprehensibility in cognitive pretests and for feasibility in a pilot survey.
In the qualitative part six focus groups were conducted at four university hospitals. From the data four main categories (prognosis, interprofessional cooperation, relatives, patients) with three to 15 subcategories each could be identified. The nurses described situations requiring palliative care consults that related to the severity of the disease, the therapeutic course, communication within the team and between team and patient/relatives, and typical characteristics of patients and relatives. In addition, a professional conflict between nurses and physicians emerged. The questionnaire, which was developed after six cognitive interviews, consists of 32 items plus one open question. The pilot had a response rate of 76.7% (23/30), whereby 30 triggers were accepted with an agreement of ≥ 50%.
Intensive care nurses see various triggers, with interprofessional collaboration and the patient\'s prognosis playing a major role. The questionnaire can be used for further surveys, e.g. interprofessional triggers could be developed.
For the qualitative part of this mixed methods study, focus groups were conducted with intensive care nurses from different disciplines (surgery, neurosurgery, internal medicine), which were selected by convenience. Data were analysed using the \"content-structuring content analysis\" according to Kuckartz. For the quantitative study part, the thus identified triggers formed the basis for questionnaire items. The questionnaire was tested for comprehensibility in cognitive pretests and for feasibility in a pilot survey.
In the qualitative part six focus groups were conducted at four university hospitals. From the data four main categories (prognosis, interprofessional cooperation, relatives, patients) with three to 15 subcategories each could be identified. The nurses described situations requiring palliative care consults that related to the severity of the disease, the therapeutic course, communication within the team and between team and patient/relatives, and typical characteristics of patients and relatives. In addition, a professional conflict between nurses and physicians emerged. The questionnaire, which was developed after six cognitive interviews, consists of 32 items plus one open question. The pilot had a response rate of 76.7% (23/30), whereby 30 triggers were accepted with an agreement of ≥ 50%.
Intensive care nurses see various triggers, with interprofessional collaboration and the patient\'s prognosis playing a major role. The questionnaire can be used for further surveys, e.g. interprofessional triggers could be developed.
摘要：
目的：国际上已经开发了Triggers来识别有姑息治疗需求的重症监护患者。由于他们的工作,护士离病人很近，因此应该考虑他们的观点。在这项研究中,我们首先确定了潜在的触发因素,然后制定了一份调查问卷,以分析德国重症监护护士对这些因素的接受程度.
方法：对于混合方法研究的定性部分，焦点小组由来自不同学科的重症监护护士(外科，神经外科,内科），这是为了方便而选择的。根据库卡茨的说法，使用“内容-结构内容分析”对数据进行了分析。对于定量研究部分，由此确定的触发因素构成了问卷项目的基础。对问卷进行了认知预测试的可理解性和试点调查的可行性测试。
结果：在定性部分中，在四家大学医院进行了六个焦点小组。从数据的四个主要类别(预后，跨专业合作，亲戚,患者）可以确定3至15个亚类。护士描述了需要姑息治疗咨询的情况，这些情况与疾病的严重程度有关，治疗过程，团队内部以及团队与患者/亲属之间的沟通，以及患者和亲属的典型特征。此外,出现了护士和医生之间的职业冲突。问卷，它是在六次认知访谈后发展起来的，由32个项目加上一个悬而未决的问题组成。飞行员的反应率为76.7%(23/30),其中30个触发因素被接受，协议≥50%。
结论：重症监护护士看到各种触发因素，与专业合作和患者的预后起着重要作用。问卷可用于进一步调查,例如，可以开发跨专业触发器。
方法：对于混合方法研究的定性部分，焦点小组由来自不同学科的重症监护护士(外科，神经外科,内科），这是为了方便而选择的。根据库卡茨的说法，使用“内容-结构内容分析”对数据进行了分析。对于定量研究部分，由此确定的触发因素构成了问卷项目的基础。对问卷进行了认知预测试的可理解性和试点调查的可行性测试。
结果：在定性部分中，在四家大学医院进行了六个焦点小组。从数据的四个主要类别(预后，跨专业合作，亲戚,患者）可以确定3至15个亚类。护士描述了需要姑息治疗咨询的情况，这些情况与疾病的严重程度有关，治疗过程，团队内部以及团队与患者/亲属之间的沟通，以及患者和亲属的典型特征。此外,出现了护士和医生之间的职业冲突。问卷，它是在六次认知访谈后发展起来的，由32个项目加上一个悬而未决的问题组成。飞行员的反应率为76.7%(23/30),其中30个触发因素被接受，协议≥50%。
结论：重症监护护士看到各种触发因素，与专业合作和患者的预后起着重要作用。问卷可用于进一步调查,例如，可以开发跨专业触发器。
