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基于网络的护理干预经验——对患有慢性肌肉骨骼疼痛的女性的访谈

Experiences of a web-based nursing intervention--interviews with women with chronic musculoskeletal pain.

作者信息

Jelin Elma, Granum Vigdis, Eide Hilde

机构信息

Department of Surgery and Neurosciences, Oslo University Hospital, Oslo, Norway.

出版信息

Pain Manag Nurs. 2012 Mar;13(1):2-10. doi: 10.1016/j.pmn.2011.08.008.

Abstract

Patients with fibromyalgia must simultaneously cope with chronic pain, emotional distress, activity avoidance and disability. The majority of fibromyalgia patients are women. New interventions using information and communications technologies such as Internet applications and smart phones can be used for text-based communications between providers and patients with chronic pain. The aim of this qualitative study was to explore female patients' experiences of participating in a 4-week web-based home intervention after in-house multidimensional rehabilitation. The framework of the intervention was inspired by mindfulness-based cognitive behavioral therapy using daily diaries and situational feedback as tools. Interviews were made with seven women about their general experiences of participation, specific relationship with the therapist, communication, activity, emotions, and coping. The interviews were transcribed and analyzed using systematic text condensation. A main result was that informants experienced this follow-up program as consciousness expanding as well as both motivating and supportive. Another main result was their reported ambivalence in relation to: (1) using web-based technology; (2) experiencing feedback as challenging but positive; and (3) experiencing relationships of trust and detachment with the therapist. Web-based nursing stimulates a "zone for reflection" that may assist in the counseling and support of patients with chronic pain. However, this is a new area of research that needs to be further explored.

摘要

纤维肌痛患者必须同时应对慢性疼痛、情绪困扰、活动回避和残疾问题。大多数纤维肌痛患者为女性。使用互联网应用程序和智能手机等信息通信技术的新型干预措施可用于医护人员与慢性疼痛患者之间基于文本的沟通。这项定性研究的目的是探讨女性患者在接受院内多维度康复治疗后参与为期4周的基于网络的家庭干预的体验。该干预框架的灵感来自基于正念的认知行为疗法,使用日常日记和情境反馈作为工具。对七名女性进行了访谈,了解她们参与干预的总体体验、与治疗师的具体关系、沟通情况、活动、情绪和应对方式。对访谈内容进行了转录,并采用系统文本浓缩法进行分析。一个主要结果是,受访者认为这个后续项目能拓展意识,且具有激励和支持作用。另一个主要结果是,她们在以下方面表现出矛盾心理:(1)使用基于网络的技术;(2)认为反馈具有挑战性但却是积极的;(3)体验到与治疗师之间信任与疏离并存的关系。基于网络的护理激发了一个“反思区域”,这可能有助于对慢性疼痛患者进行咨询和支持。然而,这是一个需要进一步探索的新研究领域。

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