Katarina Hjelm, Magnus Löndahl, Per Katzman, Jan Apelqvist
Department of Community Medicine, University of Lund, Lund, Sweden.
J Clin Nurs. 2009 Jul;18(14):1975-85. doi: 10.1111/j.1365-2702.2008.02769.x.
To elucidate how diabetic patients with limb-threatening foot lesions perceive and evaluate content and organisation of treatment in a multi-place hyperbaric oxygen chamber.
To our knowledge there are no patients' evaluations of diabetes care in a high-technology area like the hyperbaric oxygen chamber. The burden on persons with diabetic foot complications might be increased if adjuvant therapy with hyperbaric oxygen therapy (HBOT) within a locked airtight vessel is given.
Explorative study.
Participants were included in the HODFU study, a prospective randomised double-blind study, designed to evaluate whether HBOT heals more chronic foot ulcers than placebo treatment with hyperbaric air. Six females and 13 males, aged 44-83 years (median 70), with diabetic foot ulcers, participated.
Focus-group interviews by an external evaluator.
Management was perceived as well-functioning with competent staff delivering quick treatment in a positive manner and in good co-operation. HBOT sessions, in groups, were described as unproblematic and pleasant, through sharing experiences with others, although time-consuming and tiring. Recognising the responsible physician and communication with other physicians in the health-care chain was perceived as problematic. Placebo treatment, when given, did not reveal any problems; many perceived HBOT as the last resort and respondents had a negative view of future health and expressed fears of new wounds and amputation.
From patients' perspective HBOT in the delivered health-care model was perceived as well-functioning, taking into consideration both technical and relational aspects of care in this high-technology environment. Communication with the patient and between different care givers, with a consistent message given and information about who is responsible and to whom one should turn, wherever treated, is the most crucial aspect of the model. Future fears need to be recognised and group interaction can be encouraged to share the burden of disease.
阐明患有威胁肢体的足部病变的糖尿病患者如何看待和评估在多处高压氧舱中的治疗内容及组织安排。
据我们所知，在高压氧舱这样的高科技领域，尚无患者对糖尿病护理的评估。如果在密闭的高压氧舱内进行高压氧治疗（HBOT）这种辅助治疗，糖尿病足并发症患者的负担可能会加重。
探索性研究。
参与者纳入了HODFU研究，这是一项前瞻性随机双盲研究，旨在评估HBOT是否比高压空气安慰剂治疗能治愈更多慢性足部溃疡。6名女性和13名男性参与，年龄44 - 83岁（中位数70岁），患有糖尿病足溃疡。
由外部评估者进行焦点小组访谈。
患者认为管理运作良好，工作人员称职，能以积极的态度和良好的合作提供快速治疗。分组进行的HBOT疗程虽耗时且累，但通过与他人分享经历，被描述为没有问题且令人愉快。患者认为识别负责医生以及与医疗保健链中的其他医生沟通存在问题。给予安慰剂治疗时未发现任何问题；许多人将HBOT视为最后手段，受访者对未来健康持负面看法，并表达了对新伤口和截肢的恐惧。
从患者角度看，在提供的医疗保健模式中，考虑到这种高科技环境下护理的技术和人际关系方面，HBOT被认为运作良好。与患者以及不同护理人员之间的沟通，提供一致的信息并告知谁负责以及无论在何处接受治疗应找谁，是该模式最关键的方面。需要认识到患者未来的恐惧，并鼓励小组互动以分担疾病负担。
