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中文慢性阻塞性肺疾病老年患者住院再入院的现象学研究。

A Phenomenological Study of Hospital Readmissions of Chinese Older People With COPD.

机构信息

The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, China.

出版信息

Gerontologist. 2017 Nov 10;57(6):1113-1122. doi: 10.1093/geront/gnw134.

Abstract

PURPOSE OF THE STUDY

Hospital readmission is prevalent among older people with chronic obstructive pulmonary disease (COPD). Studies in this area have primarily identified the associated factors. A thorough understanding of the issue can be achieved by interpreting the related experiences in its context. This study aimed to explore the lived experience of hospital readmissions of Chinese older people with COPD.

DESIGN AND METHODS

The lived experience of hospital readmissions was acquired through descriptive phenomenology. Unstructured interviews were conducted with 22 Chinese older people readmitted to a hospital for COPD. Narrative descriptions were analyzed using the phenomenological method described by Giorgi.

RESULTS

Six constituents emerged from the general structure of the lived experience. "Refraining from unnecessary readmissions" describes how older people manage COPD in relation to hospital readmissions. "Craving for survival" explains why they seek hospital readmissions. "Feeling disregarded and powerless" and "being conscious of relieving burden to families" characterize their experience of hospital readmissions. "Resigning to hospital readmissions" illustrates how they understand the phenomenon, and "living for the moment" illuminates how they live with these experiences. These constituents are interrelated in meaningful ways and comprise the whole phenomenon of hospital readmissions.

IMPLICATIONS

The Chinese older people's experience revealed that hospital readmissions are complex experiences shaped by their sociocultural context. Older people appear to accept and cope well with hospital readmissions. However, this study uncovered their unmet needs, which may undermine their dignity. The findings of this study offer implications for promoting wellness among Chinese older people with COPD.

摘要

目的

慢性阻塞性肺疾病(COPD)患者在老年人中再入院较为普遍。该领域的研究主要确定了相关因素。通过在背景下解释相关经验,可以更全面地了解这一问题。本研究旨在探讨中国 COPD 老年患者再入院的生活体验。

设计和方法

采用描述现象学方法获取再入院的生活体验。对 22 名因 COPD 再次入院的中国老年人进行了非结构化访谈。采用 Giorgi 描述的现象学方法对叙事描述进行了分析。

结果

一般生活体验结构中出现了六个成分。“避免不必要的再入院”描述了老年人如何管理 COPD 与再入院的关系。“渴望生存”解释了他们为什么寻求再入院。“感到被忽视和无能为力”和“意识到减轻家庭负担”是他们再入院的体验特征。“接受再入院”说明了他们如何理解这一现象,“活在当下”则阐明了他们如何应对这些经历。这些成分以有意义的方式相互关联,构成了再入院这一整体现象。

意义

中国老年人的体验表明,再入院是受其社会文化背景影响的复杂体验。老年人似乎接受并能很好地应对再入院。然而,本研究揭示了他们未满足的需求,这可能会损害他们的尊严。本研究的结果为促进中国 COPD 老年患者的健康提供了启示。

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