Fundamental care in the emergency room: insights from patients with life-threatening conditions in the emergency room.

Autor: Pavedahl V; School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden Holmström, Eskilstuna Västerås, Åsa, Sweden. veronica.pavedahl@kau.se., Muntlin Å; Department of Prehospital and Emergency Care and Area 3, Uppsala University Hospital, Uppsala, Sweden.; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden., Von Thiele Schwarz U; School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden Holmström, Eskilstuna Västerås, Åsa, Sweden.; Medical Management Centre, LIME, Karolinska Institutet, Stockholm, Sweden., Summer Meranius M; School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden Holmström, Eskilstuna Västerås, Åsa, Sweden., Holmström IK; School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna Västerås, Sweden Holmström, Eskilstuna Västerås, Åsa, Sweden.; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Jazyk: angličtina
Zdroj: BMC emergency medicine [BMC Emerg Med] 2024 Nov 17; Vol. 24 (1), pp. 217. Date of Electronic Publication: 2024 Nov 17.
DOI: 10.1186/s12873-024-01133-4
Abstrakt: Background: Persons who become life-threateningly ill or injured (due to for example trauma or cardiac arrest) are cared for in hospitals' designated emergency rooms at the emergency department (ED). In these rooms, the life-threatening condition and biomedical focus may reinforce a culture that value the medical-technical care. Meeting patients fundamental care needs (integrating physical, psychosocial and relational care needs) in a person-centred way might hence be challenging in emergency rooms. Little is known about how person-centred fundamental care is experienced and valued by vulnerable and exposed patients in emergency rooms. This study aims to describe fundamental care needs experienced by patients with a life-threating condition in the emergency room.
Methods: A descriptive deductive qualitative study with individual interviews were carried out with 15 patients who had been life-threateningly ill or injured and admitted in an emergency room, in Sweden. Data collection was conducted during 2022. Transcribed interviews were analyzed with deductive content analysis, based on the Fundamentals of Care framework.
Results: Despite being life-threateningly ill or injured, patients were still able to describe their unique needs-which were not only related to biomedical care. A relationship was established between healthcare professionals and the patient in the initial stage, but not maintained during their stay at the emergency room. Patients felt their physical needs were met to a greater extent than psychosocial and relational needs, despite their prioritizing the latter. Patients preferred personalized care but described care as task oriented. The physical environment limited patients from having their fundamental care needs met, and they adopted to a "patient role" to avoid adding to staff stress. The emergency room situation evoked existential thoughts.
Conclusions: This paper provides unique insights into patients' experiences of being cared for in an emergency room. From the patient perspective, physical care was not enough. Relationship, timely and personalized information, and existential needs were identified as essential fundamental care needs, which were not, or only partly met. The finding highlights the need to embed and prioritize fundamental care in practice also for patients who are life-threateningly ill or injured, which in turn calls for focus on organizational prerequisites to enable person-centred fundamental care.
Competing Interests: Declarations Ethics approval and consent to participate The study was approved by the Swedish Ethical Review Authority (Dnr. 2019 − 00506) by the date of 21-01-2019 and informed consent was collected from all the participants prior to data collection. Consent for publication Not applicable. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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