新研究突出了大流行對一線護士的影響

為臨床醫生建立支援基礎設施,以便他們擁有清晰、一致和可用的資源,使他們能夠專注于照顧患者並優化他們自己的自我護理。

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Journal of Clinical Nursing publishes study on mental and emotional toll of COVID-19

COLUMBUS – A team of nurse scientists, evidence-based practice professionals and an ethicist from The Ohio State University College of Nursing have published their findings from their multi-site study with first-hand accounts of the psychological and emotional toll that the COVID-19 pandemic has taken on front-line nurses in the U.S.

Focus groups engaging 43 staff nurses at four sites across the country (California, New York, Ohio and Pennsylvania) informed the study, which identified four central themes:

  1. The challenges the nurses faced in their work;

  2. The feelings that dominated their emotional and mental health;

  3. Coping mechanisms with varying levels of success in dealing with the pandemic; and

  4. Ethical issues they were forced to wrestle with in real time as they treated the sickest COVID-19 patients.

“We were asked to perform this study by staff RNs themselves not only to capture the history and emotions of the pandemic as it was happening, but also to learn where there were gaps that must be filled,” said Esther Chipps, PhD, clinical nurse scientist and professor of clinical nursing at The Ohio State University College of Nursing who was the lead principal investigator. “Our front-line nurses are inspirations and heroes for how they have served during the pandemic, and it is incumbent upon healthcare organizations to understand and course-correct where possible to better support them.”

Many of the nurses interviewed for this study consistently echoed similar concerns regarding internal communication issues, ever-changing protocols as the pandemic evolved, overwhelming fatigue, growing stress and anxiety among the nursing population and the ethical dilemmas associated with the magnitude of the illness and death that they witnessed among their patients.

The study, published by the international nursing journal Journal of Clinical Nursing, spotlighted the urgent need for several evidence-based approaches to mitigate the situation that hampered the front-line response to the pandemic, including:

Consistent disaster preparation and management guidelines that front-line clinicians can count on.

Interventions to build coping and resiliency skills in front-line clinicians who are trying to handle elevated levels of stress, anxiety and burnout as they care for patients such as The Ohio State University Wexner Medical Center’s Mindfulness in Motion, STAR mental health and Buckeye Paws programs, as well as Ohio State’s MINDSTRONG™/MINDBODYSTRONG™ cognitive-behavioral skills-building program.

Opportunities to reflect on the current experience and document successes and failures to build a bank of institutional knowledge and memory that includes innovative practices, surge staffing plans, personal anecdotes and other documentation so that future crises of this kind can be met from a better-informed perspective to improve organizational preparedness.

“We cannot afford to repeat the tragedy of this pandemic ever again,” Chipps said. “Part of what we can control is the support infrastructure put into place for clinicians so that they have clarity, consistency and resources available that allow them to focus on: caring for patients and optimizing their own self-care.”

Investigators for this study include leaders from The Ohio State University College of Nursing Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, (Donal O’Mathuna, PhD; Haley Roberts, BS; Sharon Tucker, PhD; Inga Zadvinskis, PhD; Cindy Zellefrow, DNP), The Ohio State University College of Nursing and The Ohio State University Wexner Medical Center (Esther Chipps, PhD), The Ohio State University College of Nursing (Marjorie Kelley, PhD; Julia Smith, EdM), UCLA Health (Pamela Miller, PhD), Columbia University College of Nursing (Allison Norfull, PhD) and Chester County Hospital, Penn Medicine (Cindy Brockway, MSN; Cheryl Monturo, PhD).

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《臨床護理雜誌》發表了關於 COVID-19 的精神和情緒損失的研究

哥倫布——來自俄亥俄州立大學護理學院的一個由護士科學家、循證實踐專業人員和倫理學家組成的團隊發表了他們多站點研究的發現,並提供了 COVID-19 對心理和情感造成的損失的第一手資料大流行已經席捲了美國的一線護士

由全國四個地點(加利福尼亞、紐約、俄亥俄和賓夕法尼亞)的 43 名護士組成的焦點小組為這項研究提供了資訊,該研究確定了四個中心主題:

  1. 護士在工作中面臨的挑戰;

  2. 支配他們情緒和心理健康的感覺;

  3. 在應對大流行方面取得不同程度成功的應對機制;和他們在治療病情最嚴重的 COVID-19 患者時被迫實時解決道德問題。

臨床護士埃絲特·奇普斯 (Esther Chipps) 博士説:“我們被要求由註冊護士自己進行這項研究,不僅是為了在大流行發生時捕捉它的歷史和情緒,還要了解哪些地方必須填補空白,”俄亥俄州立大學護理學院的科學家和臨床護理教授,他是首席首席研究員。“我們的一線護士是他們在大流行期間服務的靈感和英雄,醫療機構有責任在可能的情況下理解並糾正路線以更好地支援他們。”

本研究採訪的許多護士一致回應了類似的擔憂,包括內部溝通問題、隨著大流行的發展而不斷變化的協議、壓倒性的疲勞、護理人員中日益增加的壓力和焦慮以及與疾病和死亡嚴重程度相關的道德困境他們在病人中親眼目睹。

這項由國際護理雜誌《臨床護理雜誌》發表的研究強調了迫切需要幾種循證方法來緩解阻礙一線應對大流行的情況,包括:

一線臨床醫生可以信賴的一致的災難準備和管理指南。

旨在幫助一線臨床醫生建立應對和恢復能力技能的干預措施,這些醫生在照顧患者時試圖應對壓力、焦慮和倦怠的情況,例如俄亥俄州立大學韋克斯納醫學中心的運動正念、STAR 心理健康和七葉樹爪計劃,以及俄亥俄州立大學的MINDSTRONG™/MINDBODYSTRONG™認知行為技能培養計劃。

有機會反思當前的經驗並記錄成功和失敗,以建立機構知識和記憶庫,其中包括創新實踐、人員激增計劃、個人軼事和其他文件,以便可以通過更明智的方式應對未來的此類危機提高組織準備的觀點。

奇普斯説:“我們承受不起再次重演這種流行病的悲劇。” “我們可以控制的部分內容是為臨床醫生建立的支援基礎設施,以便他們擁有清晰、一致和可用的資源,使他們能夠專注于:照顧患者並優化他們自己的自我護理。”

這項研究的研究人員包括來自俄亥俄州立大學護理學院 Helene Fuld Health Trust 國家護理和醫療保健循證實踐研究所的領導(Donal O'Mathuna,博士;Haley Roberts,BS;Sharon Tucker,博士;Inga Zadvinskis , 博士; Cindy Zellefrow, DNP), 俄亥俄州立大學護理學院和俄亥俄州立大學韋克斯納醫學中心 (Esther Chipps, PhD), 俄亥俄州立大學護理學院 (Marjorie Kelley, PhD; Julia Smith, EdM), UCLA Health (Pamela Miller, PhD), 哥倫比亞大學護理學院 (Allison Norfull, PhD) 和 Chester County Hospital, Penn Medicine (Cindy Brockway, MSN; Cheryl Monturo, PhD)。

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