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异基因造血干细胞移植后医院护理或家庭护理 - 患者的护理和支持体验。

Hospital care or home care after allogeneic hematopoietic stem cell transplantation--patients' experiences of care and support.

机构信息

Department of Laboratory Medicine, Therapeutical Immunology, Karolinska Institutet, Stockholm, Sweden.

出版信息

Eur J Oncol Nurs. 2013 Aug;17(4):389-95. doi: 10.1016/j.ejon.2012.12.004. Epub 2013 Jan 21.

Abstract

PURPOSE

Treatment at home during the pancytopenic phase after allogeneic hematopoietic stem cell transplantation (HSCT) has been an option for patients at our center since 1998. Earlier studies have shown that home care is safe and has medical advantages. In this study, we present patients' experiences of care and support while being treated in hospital or at home during the acute post-transplantation phase.

METHOD

Patients (n = 41, 22 in hospital care and 19 in home care) answered the SAUC questionnaire at discharge (when home, or from hospital). Both statistical analysis and deductive content analysis were used.

RESULTS

The patients were highly satisfied with the care and support during the acute post-transplantation phase. Patients in home care were found to be more satisfied with care in general than patients in hospital care. The importance of safety, empathy, and encouragement from healthcare staff were expressed regardless of where care was given. Patients also felt that receipt of continuous, updated information during treatment was important and they had a strong belief in HSCT but were uncertain of the future regarding recovery.

CONCLUSIONS

The main findings of this study were that in comparison to hospital care, home care does not appear to have a significant negative effect on patients' experiences of care and support during the acute post-transplantation phase. In addition patients in home care felt safe, seen as a person and encouragement seem to empower the patients at home. Thus, this study may encourage other transplantation centers to provide home care if the patients want it.

摘要

目的

自 1998 年以来,我们中心的患者在异基因造血干细胞移植(HSCT)后全血细胞减少期可以选择在家中接受治疗。早期的研究表明,家庭护理是安全的,并且具有医学优势。在这项研究中,我们介绍了患者在急性移植后阶段住院或在家中接受治疗时的护理和支持体验。

方法

患者(n=41,22 人在住院护理,19 人在家庭护理)在出院时(在家或从医院)回答了 SAUC 问卷。我们同时使用了统计分析和演绎内容分析。

结果

患者对急性移植后阶段的护理和支持非常满意。与住院护理的患者相比,家庭护理的患者对护理的总体满意度更高。无论护理地点如何,患者都表示对医护人员的安全、同理心和鼓励的重视。患者还认为在治疗过程中持续接收更新的信息很重要,他们对 HSCT 有强烈的信心,但对康复的未来感到不确定。

结论

本研究的主要发现是,与住院护理相比,家庭护理似乎不会对患者在急性移植后阶段的护理和支持体验产生显著的负面影响。此外,家庭护理的患者感到安全,被视为一个人,鼓励似乎赋予了在家中的患者权力。因此,如果患者有需求,这项研究可能会鼓励其他移植中心提供家庭护理。

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