论文部分内容阅读
目的 以往关于心力衰竭患者自我照顾的研究强调了其重要性,特别对移民患者而言.护士在为慢性病(如心力衰竭)患者提供相关信息并促进他们积极进行自我照顾方面发挥着重要作用.本研究旨在加强研究者及护士的认识,为患有心力衰竭的移民的自我照顾提供最佳支持.方法 采用质性研究方法.2020年10-12月,对瑞典西部不同类型机构心力衰竭移民患者的护士(n=13)进行访谈.资料收集采用半结构式访谈和归纳主题分析.结果 访谈呈现的主题是护士在患者自我照顾咨询中难以“找到平衡”.护士在患者咨询过程中有如下体验:接受挑战、运用创新策略、面对“健康素养相关问题”及遵照护士工作职责.护士在为移民提供自我照顾咨询时面临多项挑战,包括语言和文化障碍、时间资源限制、患者健康素养水平较低以及法律与职业规范之间的不协调.他们认为建立和谐的护患关系对于患者自我照顾的健康促进过程至关重要.结论 要提高患者自我照顾依从性,护士必须对文化差异更加敏感,对患者进行自我照顾咨询需要适应其健康素养水平.研究结果有助于护士为生活在瑞典多民族社会的心力衰竭患者提供最佳咨询服务.卫生政策制定者应采取行动,促进所有合作伙伴之间的文化相互理解,为患者提供安全的自我照顾咨询服务.“,”Objectives:This study aims to enhance researchers' and nurses' understanding of how to best support migrant patients with heart failure in self-care management.Previous research on self-care in heart failure patients has highlighted its importance,particularly among migrant populations.Nurses play an important role in informing and engaging patients with chronic conditions like heart failure to support their active participation in self-care.However,nurses' experiences of providing self-care counseling to migrant populations with heart failure have not been studied.Methods:A qualitative study was conducted.Nurses working with migrant patients with HF (n =13)from different types of facility in Western Sweden were interviewed between October and December 2020.Data were collected using semi-structured interviews and analyzed using inductive thematic analysis.Results:The main theme that emerged from the interviews was the difficulty for nurses “tofind balance”in self-care counseling.The nurses during self-care counseling had:“to accept challenges,” “to use creative strategies,” faced “problems related to health literacy,” and “to work according to their (the nurses' ) obli-gations.” It was evident that nurses faced several challenges in counseling migrants in self-care,including language and cultural barriers,time resource constraints,low levels of health literacy,and experienced disharmony between the law and their professional norms.They perceived building caring relationships with their patients to be crucial to fostering health-promoting self-care processes.Conclusions:To increase self-care adherence,nurses must become more sensitive to cultural differences and adapt self-care counseling to patients' health literacy.The findings of this research support and challenge nurses in providing the best counsel to migrant patients with heart failure living in Sweden's multi-ethnic society.Policymakers in the health care organization should act to facilitate mutual cultural understanding between all involved partners for patient-safe self-care counseling.