Ellefsen Bodil
Institute of Nursing Science, University of Oslo, Blindern, Norway.
Scand J Caring Sci. 2002 Jun;16(2):157-64. doi: 10.1046/j.1471-6712.2002.00073.x.
Dependency as disadvantage - patients' experiences This is an empirical qualitative study of the dependent community patient. The investigation raises the question of what it is like to be a highly dependent patient and how they relate to the situation. A non-probability, volunteer sample was selected from home nursing patients in a large town in Norway. The data were collected through in-depth interviews with 15 patients in their home using a semistructured interview guide. A constant comparative approach was used for analysing data. The results show that dependency has disadvantages like constraints and burdens in daily life. The patient adjusts both in a reactive and proactive way. The constraints are apparent through reduced autonomy in daily life and limited possibilities for negotiation. The burden is demonstrated through uncertainty within the encounter situation, low esteem, and loss of privacy. Adjustment is made through planning, guidance of the carer, acceptance of the situation, positive self-image and by protection of family and carer, and placing blame on the bureaucracy. The patient reacts in a more passive, reactive way regarding circumstances connected to the health care system and in a more proactive way by trying to influence the situation in the interaction in the private sphere of the patient's home.
依赖作为不利因素——患者的经历 这是一项关于依赖社区患者的实证定性研究。该调查提出了这样一个问题:成为高度依赖的患者是什么样的,以及他们如何应对这种情况。从挪威一个大城镇的家庭护理患者中选取了一个非概率的志愿者样本。通过使用半结构化访谈指南对15名患者在家中进行深入访谈来收集数据。采用持续比较法进行数据分析。结果表明,依赖存在诸如日常生活中的限制和负担等不利因素。患者以被动和主动两种方式进行调整。限制表现为日常生活中自主性的降低和协商可能性的有限。负担则通过遭遇情境中的不确定性、自尊心低落和隐私丧失得以体现。调整是通过规划、护理人员的指导、对现状的接受、积极的自我形象以及对家庭和护理人员的保护,并归咎于官僚机构来实现的。患者在与医疗保健系统相关的情况中反应较为被动、消极,而在患者家中的私人领域互动中,通过试图影响局面则表现得更为主动。