Fraser Danielle D, Kee Carolyn C, Minick Ptlene
Critical Care Clinical Nurse Specialist, WellStar Health System, Marietta, Georgia 30060, USA.
J Adv Nurs. 2006 Sep;55(5):550-8. doi: 10.1111/j.1365-2648.2006.03946.x.
This paper reports a study of the experiences of older adults with severe chronic obstructive pulmonary disease, with the aim of gaining an understanding of how the disease had affected their lives.
Chronic obstructive pulmonary disease is a major personal and public health burden and is the fifth cause of mortality worldwide. The brief encounters that healthcare professionals have with patients in hospitals, physicians' offices and other outpatient settings are insufficient to be able to truly understand the challenges that people face in the attempt to integrate a chronic illness into their lives. Previous qualitative studies on chronic obstructive pulmonary disease have tended to focus on specific problems associated with the disease, such as fatigue and social isolation.
A hermeneutic phenomenological study was carried out with 10 older adults who participated in a local hospital's case management or pulmonary rehabilitation programme. Data were collected by interviews in 2003.
Three major themes were identified: Knowing What Works, Hanging On...Barely, and Losing Control-Gaining Control. The changes associated with chronic obstructive pulmonary disease were described as increasingly challenging and even threatening to participants' current lifestyles. The impact of dyspnoea was great and invaded almost every aspect of their lives. Participants identified the most effective methods to resolve shortness of breath.
People with severe chronic obstructive pulmonary disease have had extensive experience of managing their disease and are familiar with techniques that have helped them integrate the illness and symptoms into their lives. Nurses can synthesize patient knowledge with nursing knowledge to assist patients with severe chronic obstructive pulmonary disease to achieve their maximum quality of life.
本文报告了一项针对重度慢性阻塞性肺疾病老年患者经历的研究，旨在了解该疾病如何影响他们的生活。
慢性阻塞性肺疾病是一项重大的个人和公共卫生负担，是全球第五大致死原因。医护人员在医院、医生办公室和其他门诊环境中与患者的短暂接触，不足以真正理解人们在试图将慢性病融入生活时所面临的挑战。先前关于慢性阻塞性肺疾病的定性研究往往侧重于与该疾病相关的特定问题，如疲劳和社会隔离。
对10名参与当地医院病例管理或肺康复项目的老年人进行了诠释现象学研究。2003年通过访谈收集数据。
确定了三个主要主题：知道什么有效、勉强坚持、失去控制——获得控制。与慢性阻塞性肺疾病相关的变化被描述为对参与者当前生活方式的挑战越来越大，甚至具有威胁性。呼吸困难的影响很大，几乎侵入了他们生活的方方面面。参与者确定了缓解呼吸急促的最有效方法。
重度慢性阻塞性肺疾病患者在管理疾病方面有丰富的经验，并且熟悉有助于他们将疾病和症状融入生活的技巧。护士可以将患者的知识与护理知识相结合，以帮助重度慢性阻塞性肺疾病患者实现其最大生活质量。
