Day Rebecca, Hollywood Coral, Durrant Deborah, Perkins Paul
Sue Ryder, Leckhampton Court Hospice, Cheltenham, UK.
Consultant in Gastroenterology (Hepatology).
Int J Palliat Nurs. 2015 Aug;21(8):372-9. doi: 10.12968/ijpn.2015.21.8.372.
Ascites is an accumulation of serous fluid in the abdominal cavity. It can be caused by both malignant and non-malignant conditions and produces distressing symptoms. There have been no qualitative studies looking at the experiences of patients with non-malignant ascites.
To explore the experiences of patients living with non-malignant ascites and its management. Also, to explore the views of these patients about services available to them.
Phenomenological qualitative research study using digitally recorded semi-structured interviews.
Six adult patients with non-malignant ascites who were receiving paracentesis to manage their symptoms in an acute hospital day unit.
Participants experienced a wide variety of physical symptoms. They discussed how the ascites impacted on their social lives. They had views on diuretics, low sodium diet and paracentesis as methods of symptom management. Participants' confidence in staff performing paracentesis was a common finding, particularly as ultrasound was rarely used. While only some were suitable for liver transplant, all discussed their future care needs.
Participants' experiences of non-malignant ascites are that it has a considerable effect on their quality of life. Patients like the system of day case admission for drainage, but question whether this is sustainable. Advanced practitioners can successfully provide a paracentesis service for these patients in hospitals and potentially this is transferable to hospices. Patients seemed happy to consider the option of semi-permanent drains and pumps as methods of managing ascites.
腹水是腹腔内浆液性液体的积聚。它可由恶性和非恶性疾病引起,并产生令人痛苦的症状。目前尚无关于非恶性腹水患者经历的定性研究。
探讨非恶性腹水患者的经历及其管理情况。此外,探讨这些患者对其所获得服务的看法。
采用数字记录的半结构化访谈进行现象学定性研究。
六名患有非恶性腹水的成年患者,他们在急性医院日间病房接受腹腔穿刺术以缓解症状。
参与者经历了各种各样的身体症状。他们讨论了腹水如何影响他们的社交生活。他们对利尿剂、低钠饮食和腹腔穿刺术作为症状管理方法发表了看法。参与者对进行腹腔穿刺术的工作人员的信心是一个常见的发现,尤其是因为很少使用超声。虽然只有一些人适合肝移植,但所有人都讨论了他们未来的护理需求。
参与者对非恶性腹水的经历表明,它对他们的生活质量有相当大的影响。患者喜欢日间病例引流入院系统,但质疑其是否可持续。高级从业者可以在医院成功地为这些患者提供腹腔穿刺术服务,并且这有可能转移到临终关怀机构。患者似乎乐于考虑使用半永久性引流管和泵作为管理腹水的方法。