Williams Allison
School of Postgraduate Nursing, University of Melbourne, Carlton, Victoria, Australia.
J Adv Nurs. 2004 Apr;46(1):13-22. doi: 10.1111/j.1365-2648.2003.02961.x.
Advances in medical science and improved lifestyles have reduced mortality rates in Australia and most Western countries. As a result, there is an ageing population with a concomitant growth in the number of people living with chronic illnesses. Indeed, a significant number of people will experience multiple chronic illnesses (comorbidities) and may require admission to hospital for acute care that is superimposed on their chronic illnesses.
The aim of this study was to investigate perceptions of quality of care by patients experiencing comorbidities who required an acute hospital stay.
A qualitative descriptive design was adopted, informed by Colaizzi's phenomenological method. Single semi-structured interviews were conducted with 12 patients within 14 days of being discharged home after an acute illness episode.
Data analysis revealed three themes: poor continuity of care for comorbidities, the inevitability of something going wrong during acute care and chronic conditions persisting after discharge. Combinations of chronic illnesses and treatments affected these patients' experiences of acute care and recovery postdischarge. Medicalized conceptualizations of comorbidity failed to capture the underlying health care needs of these patients. Limitations. No generalizations can be drawn because the findings and conclusions were derived from a purposive sample of patients who agreed to participate.
These findings have implications for a comprehensive and co-ordinated approach to this group of patients, and inform the body of nursing knowledge about how patients with comorbidities experience nursing care.
医学科学的进步和生活方式的改善降低了澳大利亚及大多数西方国家的死亡率。因此，人口老龄化，慢性病患者数量随之增加。事实上，相当一部分人会患有多种慢性病（合并症），可能需要住院接受急性病护理，而这种护理是叠加在他们的慢性病之上的。
本研究旨在调查患有合并症且需要短期住院的患者对护理质量的看法。
采用质性描述性设计，以科莱齐的现象学方法为依据。在急性病发作后出院回家的14天内，对12名患者进行了单次半结构式访谈。
数据分析揭示了三个主题：合并症护理的连续性差、急性护理期间出问题的必然性以及出院后慢性病持续存在。慢性病和治疗方法的组合影响了这些患者的急性护理体验和出院后的康复情况。合并症的医学概念未能涵盖这些患者潜在的医疗保健需求。局限性：由于研究结果和结论来自同意参与的有目的的患者样本，因此无法进行概括。
这些发现对针对这组患者采取全面、协调的方法具有启示意义，并为护理知识体系提供了有关合并症患者如何体验护理的信息。
