灾害响应过程中护士救援体验质性研究的Meta整合
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摘要
目的系统评价灾害响应过程中护士救援体验。方法计算机检索PubMed、CINAHL、、Web of Science、PsycINFO(Ovid)、SAGE健康科学及护理、ProQuest健康与医学期刊全文数据库、中国生物医学文献数据库、中国知网、万方数据、维普期刊资源整合数据库,纳入关于护士救灾体验的质性研究,检索时间均设定为各数据库建库至2017年10月。文献质量的评价采用"澳大利亚JBI循证卫生保健中心(2008)质性研究质量评价标准"。采用汇集性整合的方式对结果进行综合并阐释。结果纳入15项研究进行Meta整合,提炼出64个主要研究结果,归纳为10个类别,综合形成4个整合结果:进入灾害救援现场前,对人员素质及物资准备;灾害救援工作强度大,针对性的培训及统筹管理工作尚存在不足;特殊情境下救援工作涉及的道德和法律问题需要引起关注;灾害救援中护士心理支持的给予和获得需建立在良好的心理培训基础上。结论护士在灾害救援中扮演着重要的角色,除了注重自身职业道德和伦理问题,还需提升自我应对突发事件的心理弹性。在管理层面上,医疗机构需要设置针对性的培训项目,涵盖护士的心理素质培养、契合灾害救援的情景式培训和相关伦理、法律信息的传递。此外,从国家和地方政府层面,需要协调和管理各方救援团队,保证救援工作部署的精细化、精准化。
Objective To systematically review the rescue experience of nurses in disaster response. Methods Databases including PubMed, CINAHL, Web of Science, PsycINFO(Ovid), SAGE, ProQuest, CBM, CNKI, Wanfang data and VIP were searched from the inception to October 2017. Qualitative studies of the rescue experience of nurses participating in disaster response were collected. JBI Critical Appraisal Tool for qualitative studies was used to evaluate the quality of each study and the results were integrated by Meta synthesis. Results Fifteen studies were included in Meta-integration, and 64 major findings were extracted, which were summarized into 10 categories. Finally, 4 integration results were formed: adequate qualified staff and materials, inadequate targeted training and co-ordination of management, more attention to moral and legal issues involved in the relief and good psychological training for nurses. Conclusion Nurses play an important role in disaster relief. In addition to more importance to their own professional ethics,they also need to enhance their resilience to emergencies. Targeted training programs that cover nurses ' psychological quality training,situational training of disaster relief and related ethics and legal information are needed. Besides, there is a need to coordinate and manage the rescue teams so as to ensure the refinement and precision of rescue deployment.
Objective To systematically review the rescue experience of nurses in disaster response. Methods Databases including PubMed, CINAHL, Web of Science, PsycINFO(Ovid), SAGE, ProQuest, CBM, CNKI, Wanfang data and VIP were searched from the inception to October 2017. Qualitative studies of the rescue experience of nurses participating in disaster response were collected. JBI Critical Appraisal Tool for qualitative studies was used to evaluate the quality of each study and the results were integrated by Meta synthesis. Results Fifteen studies were included in Meta-integration, and 64 major findings were extracted, which were summarized into 10 categories. Finally, 4 integration results were formed: adequate qualified staff and materials, inadequate targeted training and co-ordination of management, more attention to moral and legal issues involved in the relief and good psychological training for nurses. Conclusion Nurses play an important role in disaster relief. In addition to more importance to their own professional ethics,they also need to enhance their resilience to emergencies. Targeted training programs that cover nurses ' psychological quality training,situational training of disaster relief and related ethics and legal information are needed. Besides, there is a need to coordinate and manage the rescue teams so as to ensure the refinement and precision of rescue deployment.
引文
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[15]刘喜文,冯慧敏,袁桢德.护理人员在地震救灾中的体验[J].护理研究,2012,26(7C):1935-1938.DOI:10.3969/j.issn.1009-6493.2012.21.007.
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[18]李莘,罗艳华,翟丽玲,等.地震灾区救护护士心理反应与应对方式的分析[J].中华护理杂志,2008,43(12):1070-1072.DOI:10.3761/j.issn.0254-1769.2008.12.004.
[19]Nasrabadi A N,Naji H,Mirzabeigi G,et al.Earthquake Relief:Iranian Nurses’Responses in Bam,2003,and Lessons Learned[J].Int Nurs Re,2007,54(1):13-18.DOI:10.1111/j.1466-7657.2007.00495.x.
[20]Shih F J,Liao Y C,Chan S M,et al.The Impact of the 9-21Earthquake Experiences of Taiwanese Nurses as Rescuers[J].Soc Sci Med,2002,55(4):659-672.DOI:10.1016/S0277-9536(01)00194-0.
[21]Richardson S,Ardagh M,Grainger P,et al.A Moment in Time:Emergency Nurses and the Canterbury Earthquakes[J].Int Nurs Re,2013,60(2):188-195.DOI:10.1111/inr.12013.
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[23]马衣努尔·托合提,闫雪梅,等.新疆732名基层护士突发公共卫生事件应急能力的现况调查[J].护理学报,2017,24(24):35-38.DOI:10.16460/j.issn1008-9969.2017.24.035.
[24]尹照华,赵燕,王培琴,等.军队医院救援护士平时心理健康状态及睡眠状况的调查[Z].北京:2014,189-191.
[25]周袖宗,张华鸣.灾害医学紧急救治的伦理冲突及对策探讨[J].中华灾害救援医学,2014,2(7):362-365.DOI:10.13919/j.issn.2095-6274.2014.07.001.
[26]李定丽,吴瑾文,周丹.2017年九寨沟地震后72 h放射科护理组织管理实践[J].护理学报,2017,24(23):13-15.DOI:10.16460/j.issn1008-9969.2017.23.013.
[27]张虹.浙江省自然灾害医疗救援法律制度评析[J].法制与社会,2011(5):36-39.DOI:10.3969/j.issn.1009-0592.2011.05.018.
[28]何一帆,李皓桓.灾害救援环境下的医学伦理学危机分阶段预防方法探讨[J].医学与社会,2013,26(11):4-6.
[29]郑静晨.灾害救援医学的现代化、标准化与国际化[J].中华灾害救援医学,2013,1(1):1-4.DOI:10.3969/j.issn.2095-6275.2013.01.001.本文编辑吴艳妮
[2]Hammad K S,Arbon P,Gebbie K M.Emergency Nurses and Disaster Response:An Exploration of South Australian Emergency Nurses’Knowledge and Perceptions of Their Roles in Disaster Response[J].Australas Emerg Nurs J,2011,14(2):87-94.DOI:10.1016/j.aenj.2010.10.002.
[3]陈向明.质的研究方法与社会科学研究[M].北京:教育科学出版社,2000.
[4]Joanna Briggs Institute.Critical Appraisal Tools[EB/OL].[2017-12-12].http://joannabriggs.org/research/critical-appraisal-tools.html.
[5]胡雁.循证护理学[M].北京:人民卫生出版社,2012.
[6]Li Y H,Li S J,Chen S H,et al.Disaster Nursing Experiences of Chinese Nurses Responding to the Sichuan Ya’an Earthquake[J].Int Nurs Rev,2017,64(2):309-317.DOI:10.1111/inr.12316.
[7]Pourvakhshoori N,Norouzi K,Ahmadi F,et al.Nurse in Limbo:A Qualitative Study of Nursing in Disasters in Iranian Context[J].PLoS One,2017,12(7):1-12.DOI:10.1371/journal.pone.0181314.
[8]张华,张娜,陈洪娇.海南省三级甲等医院护士参加台风灾害救援护理体验的质性研究[J].中华现代护理杂志,2017,23(15):1975-1978.DOI:10.3760/cma.j.issn.1674-2907.2017.15.005.
[9]Rivers F M.US Military Nurses:Serving Within the Chaos of Disaster[J].Nurs Clin North Am,2016,51(4):613-623.DOI:10.1016/j.cnur.2016.07.004.
[10]Aliakbari F,Hammad K,Bahrami M,et al.Ethical and Legal Challenges Associated with Disaster Nursing[J].Nurs Ethics,2015,22(4):493-503.DOI:10.1177/0969733014534877.
[11]Li Y,Turale S,Stone T E,et al.A Grounded Theory Study of‘Turning into a Strong Nurse’:Earthquake Experiences and Perspectives on Disaster Nursing Education[J].Nurse Educ Today,2015,35(9):e43-e49.DOI:10.1016/j.nedt.2015.05.020.
[12]Zhou W J,Turale S,Stone T E,et al.Chinese Nurses’Relief Experiences Following Two Earthquakes:Implications for Disaster Education and Policy Development[J].Nurse E-duc Pract,2015,15(1):75-81.DOI:10.1016/j.nepr.2014.06.011.
[13]Kayama M,Akiyama T,Ohashi A,et al.Experiences of Municipal Public Health Nurses Following Japan’s Earthquake,Tsunami,and Nuclear Disaster[J].Publ Health Nurs,2014,31(6):517-525.DOI:10.1111/phn.12140.
[14]Sloand E,Ho G,Kub J.Experiences of Nurse Volunteers in Haiti after the 2010 Earthquake[J].Res Theory Nurs Pract,2013,27(3):193-213.DOI:10.1891/1541-6577.27.3.193.
[15]刘喜文,冯慧敏,袁桢德.护理人员在地震救灾中的体验[J].护理研究,2012,26(7C):1935-1938.DOI:10.3969/j.issn.1009-6493.2012.21.007.
[16]Shih F,Turale S,Lin Y,et al.Surviving a Life-threatening Crisis:Taiwan’s Nurse Leaders’Reflections and Difficulties Fighting the SARS Epidemic[J].J Clin Nurs,2009,18(24):3391-3400.DOI:10.1111/j.1365-2702.2008.02521.x.
[17]杨燕妮,肖东霞,程红缨,等.护理人员参加汶川地震现场救援体验的质性研究[J].解放军护理杂志,2009,26(15):5-7.DOI:10.3969/j.issn.1008-9993.2009.15.002.
[18]李莘,罗艳华,翟丽玲,等.地震灾区救护护士心理反应与应对方式的分析[J].中华护理杂志,2008,43(12):1070-1072.DOI:10.3761/j.issn.0254-1769.2008.12.004.
[19]Nasrabadi A N,Naji H,Mirzabeigi G,et al.Earthquake Relief:Iranian Nurses’Responses in Bam,2003,and Lessons Learned[J].Int Nurs Re,2007,54(1):13-18.DOI:10.1111/j.1466-7657.2007.00495.x.
[20]Shih F J,Liao Y C,Chan S M,et al.The Impact of the 9-21Earthquake Experiences of Taiwanese Nurses as Rescuers[J].Soc Sci Med,2002,55(4):659-672.DOI:10.1016/S0277-9536(01)00194-0.
[21]Richardson S,Ardagh M,Grainger P,et al.A Moment in Time:Emergency Nurses and the Canterbury Earthquakes[J].Int Nurs Re,2013,60(2):188-195.DOI:10.1111/inr.12013.
[22]赵扬,孙岩峰,郑金光,等.灾害救援训练中医疗队员救援能力培养[J].中华灾害救援医学,2016,4(5):271-273.DOI:10.13919/j.issn.2095-6274.2016.05.010.
[23]马衣努尔·托合提,闫雪梅,等.新疆732名基层护士突发公共卫生事件应急能力的现况调查[J].护理学报,2017,24(24):35-38.DOI:10.16460/j.issn1008-9969.2017.24.035.
[24]尹照华,赵燕,王培琴,等.军队医院救援护士平时心理健康状态及睡眠状况的调查[Z].北京:2014,189-191.
[25]周袖宗,张华鸣.灾害医学紧急救治的伦理冲突及对策探讨[J].中华灾害救援医学,2014,2(7):362-365.DOI:10.13919/j.issn.2095-6274.2014.07.001.
[26]李定丽,吴瑾文,周丹.2017年九寨沟地震后72 h放射科护理组织管理实践[J].护理学报,2017,24(23):13-15.DOI:10.16460/j.issn1008-9969.2017.23.013.
[27]张虹.浙江省自然灾害医疗救援法律制度评析[J].法制与社会,2011(5):36-39.DOI:10.3969/j.issn.1009-0592.2011.05.018.
[28]何一帆,李皓桓.灾害救援环境下的医学伦理学危机分阶段预防方法探讨[J].医学与社会,2013,26(11):4-6.
[29]郑静晨.灾害救援医学的现代化、标准化与国际化[J].中华灾害救援医学,2013,1(1):1-4.DOI:10.3969/j.issn.2095-6275.2013.01.001.本文编辑吴艳妮