พฤติกรรมสนับสนุนของพยาบาลและอุปสรรคในการดูแลระยะสุดท้าย ที่หน่วยงานอุบัติเหตุและฉุกเฉิน โรงพยาบาลพหลพลพยุหเสนา จังหวัดกาญจนบุรี

Abstract

Death in the trauma and emergency department is a common event. Nurses is an important person to facilitate patients’ death with dignity. This descriptive study aimed to explore nurse’s supportive behaviors and nurse’s obstacles in providing end-of-life care in the trauma and emergency department, Phaholpolpayuhasaena Hospital, Kanchanaburi province. The framework of this study was based upon literature review. The study sample included 26 registered nurses working in the trauma and emergency department, Phaholpolpayuhasaena Hospital, Kanchanaburi province. The instruments used were the nurse’s supportive behaviors and the nurse’s obstacles in providing end-of-life care questionnaires (Beckstrand et al., 2008). The questionnaires were tested for their reliability and yielded a Cronbach’s alpha coefficient of 0.94 and 0.95, respectively. The study findings were as follows: 1.Nurse’s supportive behaviors means ranged from 0.81 to 3.73 (on a scale of 0-5). The three behaviors with the lowest mean scores included having a supportive person outside of the work setting who will listen to you after the death of your patient (X = 0.81, S.D. = 1.10), having a fellow nurse put his or her arm around you, hug you, pat you on the back or give some other kind of brief physical support after the death of your patient (X = 0.92, S.D. = 1.26), and letting the social worker, nursing supervisor, or religious leader take primary care of the grieving family (X = 1.38, S.D. = 1.44); and 2.Obstacles in providing end-of-life care means ranged from 2.08 to 3.92 (on a scale of 0-5). The three obstacles with the highest mean scores were restriction of family members in the emergency department during resuscitation (X = 3.92, S.D. = 1.16), being called away from the patient and his/her family because of the need to help another nurse care for his/her patients (X = 3.77, S.D. = 1.36), and not knowing the patient’s wishes regarding continuing with treatments and tests because of the inability to communicate due to a depressed neurological status or pharmacologic sedation (X = 3.77, S.D. = 1.14). The findings from this study can be used as basic information for further development of end-of-life care in the trauma and emergency department.