Gustafsson Birgitta Akesdotter, Ponzer Sari, Heikkilä Kristiina, Ekman Sirkka-Liisa
Department of Neurobiology, Caring Sciences and Society, Division Nursing and Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
J Adv Nurs. 2007 Oct;60(1):20-8. doi: 10.1111/j.1365-2648.2007.04372.x.
This paper is a report of a study to explore older people's experiences of their lived bodies during the perioperative period for a hip or knee replacement.
Replacement surgery of a major joint for older people suffering from osteoarthritis is an established treatment in developed countries. Scientific knowledge is available on replacement surgery from several perspectives, but not about older people's experiences of the entire perioperative period of a replacement procedure.
A qualitative longitudinal study was conducted between 2002 and 2004. Audiotaped interviews were carried out with 12 older people, on five different occasions during the perioperative period. The data were analysed using latent qualitative content analysis.
The perioperative period of a hip or knee replacement can be regarded as a process of transition which includes six critical phases. The transition was supported with the dream of becoming as able-bodied as previously in life, by having surgery. In addition, our findings revealed that the care recipients lacked knowledge about the surgical intervention as a whole.
The meaning of having joint replacement surgery was to overcome the confinement of living with a painful and unreliable body. Furthermore, care recipients struggled to regain a body in charge and control of their lives, yet from a new starting point. The care recipients were not prepared for the transitional changes through the perioperative period. Further research is needed to develop an appropriate programme for patient care during the perioperative period, in order to facilitate the process of transition.
本文报告一项研究,旨在探索老年人在髋关节或膝关节置换手术围手术期对其身体体验的经历。
对于患骨关节炎的老年人而言,大关节置换手术在发达国家已是一种既定的治疗方法。从多个角度都能获取关于置换手术的科学知识,但对于老年人在置换手术整个围手术期的体验却了解不足。
在2002年至2004年期间开展了一项定性纵向研究。在围手术期的五个不同时间点,对12名老年人进行了录音访谈。采用潜在定性内容分析法对数据进行分析。
髋关节或膝关节置换手术的围手术期可被视为一个过渡过程,该过程包括六个关键阶段。通过手术,“变得像从前一样身体健全”的梦想支撑着这一过渡。此外,我们的研究结果显示,接受护理者对整个手术干预缺乏了解。
进行关节置换手术的意义在于克服因身体疼痛且功能不可靠而带来的限制。此外,接受护理者努力从一个新的起点重新获得对自己生活负责和掌控的身体。接受护理者对围手术期的过渡性变化毫无准备。需要进一步开展研究,以制定一个围手术期患者护理的合适方案,从而促进过渡过程。