"You're kind of at war with yourself as a nurse": Perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder
"You're kind of at war with yourself as a nurse": Perspectives of inpatient nurses on treating people who present with a comorbid opioid use disorder
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DOI：
10.1371/journal.pone.0224335
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发表时间：
2019-10-24
期刊：
影响因子：
3.7
通讯作者：
Wurcel, Alysse G.
中科院分区：
文献类型：
--
作者：
Horner, Gabrielle;Daddona, Jeff;Wurcel, Alysse G.
背景在阿片类药物流行期间，卫生保健工作者遇到越来越多的患者患有阿片类药物使用障碍以及复杂的社会，行为和医疗问题。在医院的所有临床医生中，护士花在阿片类药物使用障碍住院患者身上的时间最多，但很少有研究探索他们在照顾这一人群方面的经验。本研究的目的是评估的态度，看法，和培训需求的护士在住院设置时，照顾病人谁有阿片类药物使用disorder.MethodsOne对一的深入访谈进行了与护士工作在一个大型学术医疗中心在波士顿，MA，使用半结构化的面试指南。通过电子邮件通知和随后的雪球抽样招募护士。访谈记录，转录和分析使用扎根theory approach.ResultsData从深入访谈22名护士被分为六个主题：（1）耻辱，（2）评估和治疗疼痛，（3）的感觉烧了，（4）供应商之间的沟通，（5）安全和保障，（6）改变的机会。这些主题被组织在社会生态模型的四个生态层次内：I）社会背景，II）医院环境，III）人际互动，和IV）个人因素。护士认识到阿片类药物使用障碍患者在住院期间面临的斗争，如疼痛，戒断和耻辱，并阐述了这些挑战如何转化为护士的专业和情绪压力。护士们提出了建议，医院可以通过这些建议来简化对这一人群的护理，包括扩大护士的角色支持和更结构化的政策，照顾病人谁目前与共病阿片类药物使用disorder.ConclusionOur研究结果强调，有必要制定计划，针对组织文化和住院护士的生活质量，以最终提高护理质量的病人谁目前与阿片类药物使用disorder.
BackgroundIn the midst of an opioid epidemic, health care workers are encountering an increasing number of patients who have opioid use disorder in addition to complex social, behavioral and medical issues. Of all the clinicians in the hospital, nurses spend the most time with hospitalized patients who have opioid use disorder, yet there has been little research exploring their experiences in caring for this population. The objective of this study was to assess the attitudes, perceptions, and training needs of nurses in the inpatient setting when caring for patients who have opioid use disorder.MethodsOne-on-one in-depth interviews were conducted with nurses working at a large academic medical center in Boston, MA, using a semi-structured interview guide. Nurses were recruited via email notifications and subsequent snowball sampling. Interviews were recorded, transcribed and analyzed using a grounded theory approach.ResultsData from in-depth interviews with 22 nurses were grouped into six themes: (1) stigma, (2) assessing & treating pain, (3) feelings of burn out, (4) communication between providers, (5) safety & security, and (6) opportunities for change. These themes were organized within four ecological levels of the Socio-Ecological Model: I) societal context, II) hospital environment, Ill) interpersonal interactions, and IV) individual factors. Nurses were cognizant of the struggles that patients who have opioid use disorder confront during hospitalization such as pain, withdrawal and stigma, and elaborated on how these challenges translate to professional and emotional strain among nurses. Nurses offered recommendations by which the hospital could streamline care for this population, including expanded role support for nurses and more structured policies regarding care for patients who present with a comorbid opioid use disorder.ConclusionOur results highlight the need for the development of programs targeting both organizational culture and the inpatient nurse quality of life to ultimately enhance quality of care for patients who present with opioid use disorder.