Department of Speech-Language Pathology, University of Toronto, Ontario, Canada.
Dysphagia. 2010 Mar;25(1):26-34. doi: 10.1007/s00455-009-9225-0. Epub 2009 Aug 6.
The objectives of this study were (1) to compare and contrast the psychological issues perceived by patients with oropharyngeal dysphagia and explore if the differences relate to recovery trajectory, and (2) to determine whether patients, caregivers, and clinicians had different perceptions of how psychological issues interacted with the lung and nutrition issues as consequences of dysphagia. Two focus groups (one each of acute and chronic patients) were conducted with a total of 8 participants. Four focus groups (3 with clinicians and 1 with caregivers) were also conducted. Through the constant comparison method of grounded theory, the differences in perceptions between acute and chronic patients with dysphagia as well as clinicians and caregivers were explored using theoretical sampling. Two themes evolved: (1) acute and chronic patients differed on how they perceived and prioritized major psychological dimensions; (2) acute patients, chronic patients, caregivers, and clinicians varied in their perceptions of how psychological issues interacted with lung and nutrition issues. The qualitative methodology was successful in identifying contrasting opinions on psychological issues of dysphagia between acute and chronic patients, which differ from the perspectives of clinicians and caregivers. It is important for treating clinicians to be aware of psychological issues, to address them according to the patients' clinical recovery, and to consider the interplay between psychological and biomedical consequences.
本研究的目的是(1)比较和对比有或无口咽吞咽困难的患者感知到的心理问题,并探讨这些差异是否与恢复轨迹有关,以及(2)确定患者、护理人员和临床医生对心理问题如何与吞咽困难的肺部和营养问题相互作用的看法是否不同。采用扎根理论的不断比较方法,通过理论抽样,探讨了急性和慢性吞咽困难患者以及临床医生和护理人员之间的看法差异。出现了两个主题:(1)急性和慢性吞咽困难患者在感知和优先考虑主要心理维度方面存在差异;(2)急性患者、慢性患者、护理人员和临床医生对心理问题与肺部和营养问题相互作用的看法存在差异。定性方法成功地确定了急性和慢性患者在吞咽困难的心理问题上的对比观点,这些观点与临床医生和护理人员的观点不同。治疗临床医生了解心理问题、根据患者的临床恢复情况解决这些问题以及考虑心理和生物医学后果之间的相互作用非常重要。
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