实践全人关顾的困难及克服方法之探讨

An Exploration of the Difficulties in Practicing Holistic Care by Nurses in Clinical Setting and Their Overcoming Strategies

摘要: 护士人手短缺是世界上普遍存在的问题，在香港，护士人手不足的情况尤为严重，护士与病人比例越高，代表护士每班需照顾的个案越多、越繁忙，而护士的工作量多寡也会对病人服务的质素构成直接影响。研究目的：探讨香港医院管理局辖下急症医院的护士在临床工作上提供「全人关顾」时遇到哪些困难及其克服方法。方法：于2014年9月至2015年5月期间以个别访谈的方式，访问了15位临床护士，并采用描述性的质性研究方法，对访谈内容作分析。结果：遇到的困难经分析后出现三个主题，分别为1) 处理不同人的需要；2) 工作上的限制；3) 自我管理。主要为处理一些较难照顾的病人，例如无理、抑郁及未能治疗或面对死亡。另处理家属情绪也不容易。而他们克服这些困难方法有自我调节，透过别人帮助及信仰上的支持。总结：受访护士普遍认为人手缺乏导致照顾欠妥善，但病人都颇接纳他们的服务及反应正面。

Abstract: Shortage of nurses is a common problem in the world. In Hong Kong, the shortage of nurses is par-ticularly serious. The nurse’s workload directly influences the quality of patient care. Objective: To explore the difficulties encountered by clinical nurses in providing “Holistic Care” in the acute hospitals of the Hospital Authority of HKSAR. Method: The qualitative study approach using indi-vidual interview was adopted, and a total of 15 clinical nurses were interviewed during the period from September 2014 to May 2015. The interview was transcribed verbatim and subject to content analysis. Result: Three themes emerging from work difficulties included: 1) managing different people needs; 2) limitation at work; 3) self-management. The most difficult ones were mainly from patients who were more difficult to take care of, such as unreasonable, depressed and failed to treat or facing death, and it was not easy to deal with the relatives’ emotion. The interviewees overcome these difficulties through self-regulation, the help of others and faith support. Conclusion: The interviewees generally considered that the lack of manpower led to inadequate care, but patients were quite receptive to their services and their responses were positive.