Martin Linda, Farrell Michael, Lambrenos Karina, Nayagam Duria
Alder Hey - Royal Liverpool Children's NHS Trust, Liverpool, UK.
J Adv Nurs. 2003 Sep;43(5):478-87. doi: 10.1046/j.1365-2648.2003.02745.x.
The Ilizarov technique has become an established method in the treatment of children with serious skeletal disorders. Whilst the technique is acknowledged for solving difficult conditions, the application of the external fixator marks the beginning of an arduous treatment programme. Research has suggested that undergoing such treatment can negatively impact upon the physical and psychological well-being of the young person. Yet limitations in research design reduce the usefulness of the findings, given in that most of the previous studies have used retrospective, quantitative data collection approaches, often with a heterogeneous sample population. We wished to gain a richer insight into the experiences of adolescents living with the frame by drawing on both qualitative and quantitative approaches.
To explore adolescents' perceptions of the anticipated and actual impact of the Ilizarov frame on aspects of daily activity.
A mixed-method approach, using a prospective and longitudinal study design.
Fifteen adolescents undergoing the Ilizarov treatment were contacted at several predetermined time-points during the course of their treatment to share their perceptions of living with the frame. At several of these points semi-structured interviews were used to ascertain their perceptions, whilst quantitative data were gained at all time-points by adolescents completing a range of psychometric measures.
Adolescents found that life with the frame was not as bad as anticipated, and they adopted a pragmatic approach, appreciating that this was something they 'just had to get through'. Peers had a substantial role in supporting their friend to adjust and cope with the frame. Psychometric scores were largely within normal limits.
This study suggests that, while the Ilizarov treatment is demanding for adolescents, it is one that they can tolerate without sustained adverse psychological impact.
伊里扎洛夫技术已成为治疗患有严重骨骼疾病儿童的既定方法。虽然该技术因能解决疑难病症而得到认可，但外固定器的应用标志着一项艰巨治疗计划的开始。研究表明，接受这种治疗可能会对年轻人的身心健康产生负面影响。然而，研究设计的局限性降低了研究结果的实用性，因为之前的大多数研究都采用回顾性、定量的数据收集方法，样本群体往往具有异质性。我们希望通过定性和定量方法更深入地了解佩戴外固定架青少年的经历。
探讨青少年对伊里扎洛夫外固定架对日常活动各方面预期和实际影响的看法。
采用混合方法，采用前瞻性纵向研究设计。
在15名接受伊里扎洛夫治疗的青少年治疗过程中的几个预定时间点与他们联系，分享他们对佩戴外固定架生活的看法。在其中几个时间点，通过半结构化访谈来确定他们的看法，同时在所有时间点通过青少年完成一系列心理测量指标来获取定量数据。
青少年发现佩戴外固定架的生活并不像预期的那么糟糕，他们采取了务实的态度，认识到这是他们“必须挺过去的事情”。同龄人在支持朋友适应和应对外固定架方面发挥了重要作用。心理测量分数大多在正常范围内。
本研究表明，虽然伊里扎洛夫治疗对青少年要求很高，但他们能够耐受，不会受到持续的不良心理影响。
