Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
J Clin Nurs. 2010 Nov;19(21-22):3112-22. doi: 10.1111/j.1365-2702.2010.03428.x.
The aim was to elucidate patients' lived experience of the care pathway of going through open surgery for abdominal aortic aneurysm.
Open surgical treatment has a great impact on patients' health-related quality of life both before and after treatment. The transition from being independent and asymptomatic to dependent on nursing care can be difficult. To facilitate this process and provide high-quality care, patients' needs must be better understood.
An exploratory descriptive design was chosen to describe and understand patients' lived experience.
Audio-taped interviews were performed three months postoperatively, covering the care pathway before and after surgery. Interviews were analysed with qualitative content analysis.
The informants made a transition from becoming aware of the deadly risk associated with abdominal aortic aneurysm to gradually understanding the physical and emotional impact of the surgical procedure during the recovery process. The experience of not understanding fully the risks of undergoing surgery or its consequences on daily life made the informants unprepared for complications and limitations during the recovery period. Many concerns emerged, with a need for more dialogue and opportunities to understand their own care than those provided by the health care staff.
To facilitate the transition process, health care staff should consider patients' unpreparedness for the physical and emotional impact that can follow diagnosis and treatment for abdominal aortic aneurysm and recognise the need for dialogue to enhance participation during recovery.
Throughout the care pathway, patients' need for information and for opportunities to reflect on bodily and emotional reactions to the diagnosis and treatment of abdominal aortic aneurysm should be recognised by nurses and physicians to support patients getting realistic expectations of the consequences of treatment and facilitate participation in decisions concerning care and medical treatment.
本研究旨在阐明患者接受开放性腹主动脉瘤手术治疗的护理路径的真实体验。
开放性手术治疗对患者治疗前后的健康相关生活质量有重大影响。从独立无症状到依赖护理的转变可能很困难。为了促进这一过程并提供高质量的护理，必须更好地了解患者的需求。
选择探索性描述性设计来描述和理解患者的真实体验。
术后三个月进行了录音访谈，涵盖了手术前后的护理路径。使用定性内容分析对访谈进行了分析。
患者从意识到腹主动脉瘤相关的致命风险到在恢复过程中逐渐了解手术对身体和情绪的影响，经历了一个转变。对接受手术的风险或对日常生活的影响没有充分理解，导致患者对恢复期的并发症和限制没有做好准备。出现了许多担忧，他们需要更多的对话和机会来了解自己的护理需求，而不仅仅是医疗保健人员提供的。
为了促进过渡过程，医护人员应考虑到患者对腹主动脉瘤诊断和治疗后可能出现的身体和情绪影响的准备不足，并认识到需要进行对话，以增强患者在恢复期间的参与度。
在整个护理路径中，护士和医生应认识到患者对信息的需求，以及对诊断和治疗腹主动脉瘤引起的身体和情绪反应进行反思的机会，以支持患者对治疗后果的现实期望，并促进他们参与护理和医疗决策。
