Needing permission: The experience of self-care and self-compassion in nursing: A constructivist grounded theory study
Needing permission: The experience of self-care and self-compassion in nursing: A constructivist grounded theory study
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DOI：
10.1016/j.ijnurstu.2019.103436
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发表时间：
2020-01-01
影响因子：
8.1
通讯作者：
Seers, Kate
中科院分区：
文献类型：
--
作者：
Andrews, Hannah;Tierney, Stephanie;Seers, Kate
背景：医疗保健是在不断变化的文化中提供的，许多护士强调这对他们自己的健康的影响。然而，缺乏文献关注护士如何照顾自己，因为他们试图在一项具有挑战性的工作中提供富有同情心的护理。目的：本研究探讨护士的自我照顾和自我同情的经验，以及这些经验如何与对病人的同情护理有关。设计：采用建构主义理论为基础的方法来发展对护士经验的理论理解。背景：本研究包括来自英国（UK）两个国家卫生服务（NHS）信托基金的参与者。对象：采用有目的抽样和理论抽样的方法，招募不同资历级别的普通护士、心理健康护士和学习障碍护士。方法：于2015年9月至2016年3月进行半结构式访谈。分析是按照建构主义理论中设定的过程完成的。通过不断的比较和备忘录写作，分析从最初的编码转移到重点编码，通过理论编码，导致核心概念和类别的产生，以及理论的发展。结果：本研究共纳入30名受试者。从数据中衍生出三个概念：(1)“天生就是照顾者”——职业与角色；(2)需要一个稳定的基础；(3)管理照顾者的情绪。所有这三个概念都与一个核心过程有关：需要允许自我照顾和自我同情。护士需要得到他人和自己的许可才能自我照顾和自我同情。无法做到这一点会影响他们的健康和对他人的同情心。受访者描述了他们在自我同情方面的挣扎。帮助护士更主动地自我照顾和自我同情可能会提高他们管理情绪的能力，并防止护理的一些负面后果，如倦怠和同情疲劳。提出了一个概念性框架，该框架确定了正式许可（例如，在护理指导范围内）对于一些护士照顾自己可能是必要的。结论：研究结果表明，获得许可是使护士能够自我护理和自我同情的关键，这可能有助于他们满足患者的需求。本研究强调了自我照顾和自我同情在护理教育和护理指导中的重要性。(C) 2019 Elsevier Ltd.版权所有。
Background: Healthcare is delivered in a culture of ongoing change, with many nurses highlighting the impact of this on their own wellbeing. However, there is a dearth of literature focusing on how nurses care for themselves as they try to provide compassionate care in a challenging job.Objectives: This study explored nurses' experience of self-care and self-compassion and how this may relate to compassionate care giving towards patients.Design: A constructivist grounded theory approach was used to develop a theoretical understanding of nurses' experience.Settings: This study included participants from two National Health Service (NHS) Trusts within the United Kingdom (UK).Participants: Purposive and theoretical sampling were used to recruit general, mental health and learning disability nurses, at different levels of seniority.Method: Between September 2015 and March 2016 semi-structured interviews were conducted. Analysis was completed in line with the process set out within constructivist grounded theory. Using constant comparison and memo writing, analysis moved from initial coding to focused coding, through to theoretical coding, resulting in the production of core concepts and categories, and theory development.Results: Thirty participants were included in the study. Three concepts were derived from the data: (1) 'Hardwired to be caregivers' - vocation versus role, (2) needing a stable base, (3) Managing the emotions of caring. All three concepts linked to a core process: needing permission to self-care and be self-compassionate. Nurses needed permission from others and from themselves to be self-caring and self-compassionate. An inability to do this affected their wellbeing and compassionate care giving to others. Interviewees described how they struggled particularly with self-compassion. Helping nurses to be proactively more self-caring and self-compassionate may increase their ability to manage emotions and prevent some of the negative consequences of nursing such as burnout and compassion fatigue. A conceptual framework is proposed which identifies that formal permission (e.g., within nursing guidance) may be necessary for some nurses to look after themselves.Conclusion: Findings identified the need for permission as key in enabling nurses to self-care and be self-compassionate, which may facilitate them to address patients' needs. The study highlights the importance of self-care and self-compassion within nursing education and nursing guidance. (C) 2019 Elsevier Ltd. All rights reserved.