Communication, the Key in Creating Dignified Encounters in Unexpected Sudden Death - With Stroke as Example

A Qualitative Study on the Humanistic Care Needs of Patients with Stroke and Their Families

Background

International stroke care guidelines recommend the routine assessment and management of psychological and emotional problems in patients and their families after a stroke. This study aimed to explore the humanistic nursing needs of patients with stroke and their families and provide a basis for the construction of humanistic nursing practice guidelines for advanced stroke.

Methods

From September to October 2019, using the descriptive phenomenological research method, a semi-structured interview outline was formed based on a literature review and subject group discussions. A targeted sampling method was used to investigate 21 patients with stroke and 21 family members, respectively, and their care needs were investigated in depth. Colaizzi's thematic cluster analysis was used to analyse the data, and a total of 6 themes and 14 sub-themes were summarised.

Results

The 6 themes and 14 sub-themes were as follows: ① psychological care, ② security concerns (professional personal integrity, timely response), ③ emotional care (service consciousness, positive incentives, empathy, effective communication, provision of a communication platform, personalised care), ④ respect for rights, ⑤ rehabilitation care (rehabilitation programme, professional guidance, rehabilitation configuration, continuation of services) and ⑥ family care (physical and psychological support, care guidance).

Conclusion

Among the humanistic care needs of patients with stroke and their families, the most basic physiological care accounts for the largest proportion of emotional and rehabilitation care, followed by safety care, respect for rights and family care. Based on the actual humanistic care needs of patients with stroke and their families, the practical effect of humanistic care in stroke wards can be improved. This study provides a reference for the construction of humanistic nursing practice guidelines for late stroke.

Psychological Experience of Humanistic Care Among Medical Staff in Stroke Wards: A Qualitative Research Study Conducted in China

BACKGROUND

As a special patient group, stroke patients have a significant attachment to humanistic care. However, multiple problems remain in clinical practice. Medical staff in stroke wards are the primary providers of humanistic care. Finding out the opinions of the staff that provide these medical services is vitally important for stroke patients that need access to curative and humanistic care.

OBJECTIVE

The aim of the study is to explore the psychological experiences of doctors, nurses, and physiotherapists during the implementation of humanistic care in stroke wards.

METHOD

This is a qualitative phenomenological study. Medical staff (i.e., doctors, nurses, and physiotherapists) were selected from stroke wards in general hospitals (minimum level two) from 13 cities within six provinces in China. A purposive sampling method was used until saturation (n = 18). Face-to-face or video call semi-structured interviews were conducted by using a phenomenological research method. The average interview length was 60 min (range 30-90 min). The Colaizzi seven-step method was used for analysis.

RESULTS

Four themes and 12 sub-themes were extracted from the qualitative interviews of the medicine, nursing and technology staff, as follows. ➀ The ward staff reported that the behaviors of the stroke patients gradually improved when they assisted with stroke treatment idea changes, when they paid attention to solving the patients' existing problems, and when they took the initiative to create a caring atmosphere; ➁ when humanistic care in the stroke wards was carried out with consciousness and ability improvement (including proactive caring behaviors in which vocational value was not strong and in which the whole-person rehabilitation was given attention, not just implementation), the patients' behaviors improved; ➂ the stroke wards themselves were improved (the gap between the current management and the needs of medical institutions and the gap between the rehabilitation conditions and the patients' needs were addressed); and ➃ the urgent needs of the staff in the implementation of humanistic care in stroke wards were considered (the addition of full-time posts, the effective training of humanistic care, and the construction of a more harmonious doctor-patient relationship).

CONCLUSION

In implementing humanistic care in stroke wards, the consciousness and ability of the medical staff need to be improved. In addition, the practical problems and contradictions affecting the development of humanistic care must be addressed. To improve the level of humanistic care in stroke wards, attention should be paid to the overall improvement of the personal qualities of the medical staff and the integration of a humanistic management mode.