Doering Lynn V, McGuire Anthony W, Rourke Darlene
University of California, Los Angeles School of Nursing, USA.
Am J Crit Care. 2002 Jul;11(4):333-43.
Care of cardiac surgery patients has changed substantially in the past decade, with an emphasis on streamlined procedures and shortened hospital stays. The few qualitative reports of patients' perspectives of this experience focus primarily on physical complications and discomforts during the immediate postoperative period.
To examine patients' perceptions of the quality of the nursing and medical care they received during their hospital stay after cardiac surgery.
Data were collected from a consecutive sample of 89 cardiac surgical patients who consented to participate in 2 telephone interviews at 1 week and 6 weeks after hospitalization. Patients responded to a single open-ended question: "What do you want your nurses and doctors to know to help them do a better job?" Thematic extraction analysis of patients' responses was conducted by using commercially available statistical software. Extracted themes were applied to the structure-process-outcome framework of quality of care.
Four major themes (and 12 subthemes) were identified: (1) being satisfied (having a positive experience, getting information), (2) not being cared for (feeling depersonalized, having expectations that did not match recovery experiences, not being listened to, experiencing unprofessional behavior by care providers, experiencing continued care needs after going home), (3) physical needs unmet (sleep, pain, complications, physical environment), and (4) informational needs unmet (needing more or different information).
Patients want nurses and doctors to provide a smooth transition to home, recognize the patients as individuals, prepare them honestly for their experiences with specific information, and manage pain and sleep.
在过去十年中，心脏外科手术患者的护理发生了重大变化，重点是简化手术流程和缩短住院时间。关于患者对这种经历看法的少数定性报告主要集中在术后即刻的身体并发症和不适上。
探讨患者对心脏外科手术后住院期间所接受护理和医疗质量的看法。
从连续抽取的89例心脏外科手术患者中收集数据，这些患者同意在住院后1周和6周接受2次电话访谈。患者回答一个开放式问题：“你希望你的护士和医生了解什么，以便他们能做得更好？”使用商用统计软件对患者的回答进行主题提取分析。将提取的主题应用于护理质量的结构-过程-结果框架。
确定了四个主要主题（以及12个子主题）：（1）感到满意（有积极的体验、获得信息），（2）未得到护理（感觉被忽视、期望与康复经历不符、未被倾听、经历护理人员的不专业行为、回家后仍有持续护理需求），（3）身体需求未得到满足（睡眠、疼痛、并发症、物理环境），以及（4）信息需求未得到满足（需要更多或不同的信息）。
患者希望护士和医生提供顺利的回家过渡，将患者视为个体，用具体信息诚实地让他们为自己的经历做好准备，并管理疼痛和睡眠。
