Wiederhold Dietmar, Langer Gero, Landenberger Margarete
AWO Gesundheitsdienste gGmbH, Nephrologisches Zentrum Niedersachsen, Hann. Münden.
Pflege. 2009 Oct;22(5):329-39. doi: 10.1024/1012-5302.22.5.329.
With a share of approximately 27 % of renal replacement therapies renal transplantation (RTx) has by now become a well-established alternative to dialysis. However, little is known ab-out how patients experience their new situation shortly after the RTx and about their instruction and education needs. The purpose of this phenomenological study is to describe the patients' experiences after an RTx before being discharged from the inpatient ward or from hospital and to identify topics for patient instruction and education. The method included ten semi-structured interviews with patients after a first time allogenic renal transplantation, with stable transplant function, who still received in-patient treatment. Recorded, transcribed interviews were analyzed using Colaizzi's method. The essential structure of the experiences of patients after renal transplantation can be described as a "feeling of being torn". Within this overarching theme, six sub-themes were identified: 1) weighing dialysis against transplantation, 2) dealing with the organ, 3) the experience of positive changes, 4) the self-confidence resulting from it, 5) the experience of still existing impairments and worries, and finally 6) the ensuing need for support. As a conclusion for practice it is necessary to offer an actively approaching and realistic instruction and education in order to create everyday skills and a higher degree of self-determination in the patients.
肾移植(RTx)占肾替代治疗的比例约为27%,现已成为透析的一种成熟替代方案。然而,对于患者在肾移植后不久如何体验新情况以及他们的指导和教育需求,我们知之甚少。这项现象学研究的目的是描述患者在从住院病房或医院出院前肾移植后的经历,并确定患者指导和教育的主题。该方法包括对首次同种异体肾移植后移植功能稳定且仍在接受住院治疗的患者进行十次半结构化访谈。使用科莱齐的方法对记录并转录的访谈进行分析。肾移植后患者经历的基本结构可描述为一种“矛盾感”。在这个总体主题下,确定了六个子主题:1)权衡透析与移植,2)处理移植器官,3)积极变化的体验,4)由此产生的自信心,5)仍然存在的损伤和担忧的体验,最后是6)随之而来的支持需求。作为实践结论,有必要提供积极主动且现实的指导和教育,以便培养患者的日常技能和更高程度的自主能力。