Bergjan Manuela, Schaepe Christiane
Institute of Health and Nursing Science, Charité - Universitaetsmedizin Berlin, Berlin, Germany.
J Clin Nurs. 2016 Jun;25(11-12):1729-39. doi: 10.1111/jocn.13191. Epub 2016 Apr 14.
The aim of the study was to explore renal nurses' experiences, strategies and challenges with regard to the patient education process in peritoneal dialysis.
Patient education in peritoneal dialysis is essential to developing a successful home-based peritoneal dialysis program. In this area research is scarce and there is a particular lack of focus on the perspective of the renal nurse.
Qualitative design formed by thematic qualitative text analysis.
Five group interviews (n = 20) were used to explore the challenges peritoneal dialysis nurses face and the training strategies they use. The interviews were analyzed with thematic qualitative content analysis using deductive and inductive subcategory application.
The findings revealed the education barriers perceived by nurses that patients may face. They also showed that using assessment tools is important in peritoneal dialysis patient education, as is developing strategies to promote patient self-management. There is a need for a deeper understanding of affective learning objectives, and existing teaching activities and materials should be revised to incorporate the patient's perspective. Patients usually begin having questions about peritoneal dialysis when they return home and are described as feeling overwhelmed. Adapting existing conditions is considered a major challenge for patients and nurses.
The results provided useful insights into the best approaches to educating peritoneal dialysis patients and served to raise awareness of challenges experienced by renal nurses. Findings underline the need for nosogogy - an approach of teaching adults (andragogy) with a chronic disease. Flexibility and cooperation are competencies that renal nurses must possess.
Still psychomotor skills dominate peritoneal dialysis patient training, there is a need of both a deeper understanding of affective learning objectives and the accurate use of (self-)assessment tools, particularly for health literacy.
本研究旨在探讨肾脏科护士在腹膜透析患者教育过程中的经验、策略及挑战。
腹膜透析患者教育对于成功开展家庭腹膜透析项目至关重要。该领域研究匮乏，尤其缺乏对肾脏科护士视角的关注。
采用主题定性文本分析的定性设计。
通过五次小组访谈（n = 20）来探究腹膜透析护士面临的挑战以及他们所采用的培训策略。运用演绎和归纳子类别应用的主题定性内容分析法对访谈进行分析。
研究结果揭示了护士所察觉到的患者可能面临的教育障碍。还表明在腹膜透析患者教育中使用评估工具很重要，制定促进患者自我管理的策略同样重要。需要更深入地理解情感学习目标，并且应修订现有的教学活动和材料以纳入患者视角。患者通常在回家后开始对腹膜透析产生疑问，并表示感到不知所措。适应现有状况被认为是患者和护士面临的主要挑战。
研究结果为教育腹膜透析患者的最佳方法提供了有益见解，并有助于提高对肾脏科护士所面临挑战的认识。研究结果强调了需要采用针对患有慢性病的成年人的教学方法（成人教育学）。灵活性与合作是肾脏科护士必须具备的能力。
目前腹膜透析患者培训仍以操作技能为主，需要更深入地理解情感学习目标并准确使用（自我）评估工具，尤其是针对健康素养方面。
