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患者被告知患有腹主动脉瘤的经历——筛查五年后的随访案例研究

Patients' experiences of being informed about having an abdominal aortic aneurysm - a follow-up case study five years after screening.

作者信息

Brännström Margareta, Björck Martin, Strandberg Gunilla, Wanhainen Anders

机构信息

Department of Nursing, Umeå University, Umeå, 93187 Skellefteå, Sweden.

出版信息

J Vasc Nurs. 2009 Sep;27(3):70-4. doi: 10.1016/j.jvn.2009.04.001.

Abstract

The aim of this study was to describe patients' experiences 5 years after being informed about having an abdominal aortic aneurysm (AAA), at screening, in a subgroup of patients who suffered a decrease in quality of life (QoL) 12 months after screening. Of 6 patients with a decreased QoL 12 months after AAA screening, one had died, one declined to participate and one suffered cognitive problems and was therefore excluded. The remaining 3 patients (all men, aged 79-80 years) were interviewed in their homes. The interviews were analysed using thematic content analysis. The result shows that the patients have feelings of security about offered professional care, despite awareness of having an AAA. These feelings include having a relationship of trust with the surgeon; having trust in screening, follow-up checks and the possible treatment for their AAAs; and having awareness of the severity of the disease. Furthermore, the patients experience having an AAA to be symbolically 'like a drop in the ocean.' This means having no physical problems related to AAA, and having more difficulties with other diseases or problems in life overshadows the awareness about the AAA. An observed reduction in QoL among subjects with screening-detected AAA was mainly explained by other diseases or problems that overshadow the AAA. However, the low number of participants indicates a need for extended studies on this topic.

摘要

本研究的目的是描述在筛查时被告知患有腹主动脉瘤(AAA)的患者亚组中,在筛查后12个月生活质量(QoL)下降的患者在5年后的经历。在AAA筛查后12个月生活质量下降的6例患者中,1例死亡,1例拒绝参与,1例存在认知问题,因此被排除。其余3例患者(均为男性,年龄79 - 80岁)在家中接受了访谈。采用主题内容分析法对访谈进行分析。结果显示,尽管患者知晓自己患有AAA,但他们对所提供的专业护理仍有安全感。这些感受包括与外科医生建立了信任关系;对筛查、后续检查以及AAA的可能治疗有信心;以及了解疾病的严重性。此外,患者认为患有AAA在象征意义上“就像沧海一粟”。这意味着与AAA没有身体上的问题,并且生活中其他疾病或问题带来的更多困难掩盖了对AAA的认知。在筛查发现患有AAA的受试者中观察到的生活质量下降主要是由其他疾病或问题导致的,这些疾病或问题掩盖了AAA。然而,参与者数量较少表明需要对该主题进行进一步研究。

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