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首页> 外文期刊>Progress in Palliative Care >‘Distress at the bedside in the PICU: Nurses’ and respiratory therapists’ experiences in caring for children with complex medical or neurologic conditions’
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‘Distress at the bedside in the PICU: Nurses’ and respiratory therapists’ experiences in caring for children with complex medical or neurologic conditions’

机译：“ PICU病床旁的痛苦：护士和呼吸治疗师在照料患有复杂医学或神经系统疾病的儿童方面的经验”

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Introduction nnIntensive care unit (ICU) care provided to children with complex chronic medical and neurological conditions is a frequent source of conflict and distress. nnObjective nnTo quantify the extent to which pediatric ICU (PICU) nurses (RNs) and respiratory therapists (RTs) experience distress when caring for children with complex medical and developmental disabilities, and to explore which provider characteristics lessen or increase this distress. nnMethods nnRNs and RTs at three pediatric hospitals completed an online scenario-based survey to assess their feelings toward a hypothetical patient with complex, chronic medical conditions, and neurological impairment. Twenty-four statements were created to capture features of moral distress, mismatch of expectations, and job dissatisfaction, and providers indicated degree of agreement with each statement. Responses were tabulated to create a Total Distress Score (TD) which was further subdivided into Moral Distress (MD), Mismatch of Expectations (ME), and Job Dissatisfaction (JD) sub-scores. nnResults nnOne hundred and fifty-five providers completed the survey. RNs and RTs expressed a wide variability of distress in relation to care provided to this hypothetical patient. No single demographic factor consistently accounted for the variability in distress levels. Providers who would have personally opted against aggressive treatment had a statistically significant increase in the level of distress. ME was strongly correlated with both MD and JD scores. nnConclusions nnProviding bedside care to children with complex chronic medical and neurological conditions is associated with wide variability in the level of distress for RNs and RTs. For a subset of providers, this distress can be substantial and highlights the importance of identifying and implementing strategies to mitigate this distress to create a more sustainable and effective work force.
机译：简介nn为患有复杂的慢性医学和神经疾病的儿童提供的重症监护病房（ICU）是冲突和困扰的常见来源。 nn目的nn量化小儿ICU（PICU）护士（RN）和呼吸治疗师（RT）在照料患有复杂医学和发育障碍的儿童时遇到困扰的程度，并探讨减轻或增加这种困扰的服务提供者特征。 nnMethods三家儿科医院的nnRN和RT完成了一项基于情景的在线调查，以评估他们对假设患者的复杂，慢性病和神经系统疾病的感觉。创建了二十四个陈述来捕捉道德苦恼，期望不匹配和工作不满意的特征，提供者表示与每个陈述的同意程度。将回答列表化以创建总苦恼分数（TD），该总苦恼分数进一步细分为道德苦恼（MD），期望不匹配（ME）和工作不满意（JD）子得分。 nn结果155位提供者完成了调查。 RNs和RTs表示，与向该假想患者提供的护理有关的苦恼差异很大。没有任何一个人口统计学因素能够始终如一地解释遇险水平的变化。统计上会选择不接受积极治疗的医疗服务提供者，其痛苦水平在统计学上有显着增加。 ME与MD和JD得分均密切相关。 nn结论nn为患有复杂的慢性医学和神经疾病的儿童提供床旁护理与RNs和RTs的困扰程度差异很大。对于一部分提供者来说，这种困扰可能是巨大的，并突出表明了确定和实施缓解这种困扰的战略以建立一支更可持续，更有效的劳动力队伍的重要性。

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