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一项探索临床工作人员对护理肥胖患者挑战的态度的定性研究。

A qualitative study to explore the attitude of clinical staff to the challenges of caring for obese patients.

作者信息

Lumley Elizabeth, Homer Catherine V, Palfreyman Simon, Shackley Phil, Tod Angela Mary

机构信息

Sheffield Teaching Hospitals Foundation Trust, NIHR CLAHRC-SYH, D-Floor Royal Hallamshire Hospital, Sheffield, UK.

Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK.

出版信息

J Clin Nurs. 2015 Dec;24(23-24):3594-604. doi: 10.1111/jocn.13016. Epub 2015 Oct 14.

Abstract

AIMS AND OBJECTIVES

To examine, from the perspective of staff, if obese patients have any additional care needs, and what the impact of these care requirements are on care provision. We have selected obese patients with venous leg ulceration as an example patient population to explore these questions.

BACKGROUND

Anecdotal evidence indicates obesity can increase care requirements and have implications for obesity for care provision. However, little research exists nationally or internationally that provides evidence from a health care perspective. Obesity is a contributory causative factor of lower limb ulceration. In addition to affecting the development of venous leg ulceration, obesity may also impact on the care an obese patient may require and receive.

DESIGN

Qualitative study using semi-structured in interviews and framework analysis.

METHODS

Interviews were conducted with 18 health care professionals and one focus group with 12 health care professionals who cared for patients with venous ulceration. Data were analysed to identify recurring themes relating to the impact of obesity on care provision.

RESULTS

This study found that the increasing numbers of obese patients with leg ulcers are currently presenting challenges to care delivery in many different ways. There was an impact of obesity on patient experience in terms of dignity, safety and quality. Data indicated that neither hospital nor community care services were adequately set up to meet the needs of obese patients in general.

CONCLUSION

Health care providers need to recognise that increasing numbers of overweight and obese patients are presenting challenges to care delivery. The study also indicated the need for senior strategic leadership in planning for meeting the needs of obese patients.

RELEVANCE TO CLINICAL PRACTICE

Nursing is well placed to provide specialist support to co-ordinate services for obese/oversize patients if a suitable strategic and leadership role is developed. Nurses are used to offering patients help in areas of health promotion such as smoking cessation. Lessons learnt from this area could be applied to help and encourage staff to support patients with weight management.

摘要

目的与目标

从医护人员的角度审视肥胖患者是否有任何额外的护理需求,以及这些护理需求对护理服务有何影响。我们选择患有下肢静脉溃疡的肥胖患者作为示例患者群体来探讨这些问题。

背景

传闻证据表明肥胖会增加护理需求,并对护理服务产生影响。然而,在国内或国际上,很少有研究从医疗保健的角度提供证据。肥胖是下肢溃疡的一个促成因素。除了影响下肢静脉溃疡的发展外,肥胖还可能影响肥胖患者可能需要和接受的护理。

设计

采用半结构式访谈和框架分析的定性研究。

方法

对18名医疗保健专业人员进行了访谈,并与12名护理下肢溃疡患者的医疗保健专业人员进行了一次焦点小组讨论。对数据进行分析,以确定与肥胖对护理服务影响相关的反复出现的主题。

结果

本研究发现,越来越多患有腿部溃疡的肥胖患者目前正以多种不同方式给护理服务带来挑战。肥胖在尊严、安全和质量方面对患者体验产生了影响。数据表明,无论是医院还是社区护理服务,总体上都没有充分建立起来以满足肥胖患者的需求。

结论

医疗保健提供者需要认识到,越来越多的超重和肥胖患者给护理服务带来了挑战。该研究还表明,在规划满足肥胖患者需求方面需要高层战略领导。

与临床实践的相关性

如果发展出合适的战略和领导角色,护理人员处于提供专业支持以协调肥胖/超大型患者服务的有利位置。护士习惯于在戒烟等健康促进领域为患者提供帮助。从这一领域吸取的经验教训可用于帮助和鼓励工作人员支持患者进行体重管理。

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