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自体软骨细胞植入术后患者的康复体验:一项定性研究。

Patient Experiences of Recovery After Autologous Chondrocyte Implantation: A Qualitative Study.

作者信息

Toonstra Jenny L, Howell Dana, English Robert A, Lattermann Christian, Mattacola Carl G

机构信息

Athletic Training Education Program, Department of Health and Sport Sciences, Salisbury University, MD.

Division of Physical Therapy, University of Kentucky, Lexington.

出版信息

J Athl Train. 2016 Dec;51(12):1028-1036. doi: 10.4085/1062-6050-51.12.12. Epub 2016 Nov 11.

Abstract

CONTEXT

The recovery process after autologous chondrocyte implantation (ACI) can be challenging for patients and clinicians alike due to significant functional limitations and a lengthy healing time. Understanding patients' experiences during the recovery process may assist clinicians in providing more individualized care.

OBJECTIVE

To explore and describe patients' experiences during the recovery process after ACI.

DESIGN

Qualitative study.

SETTING

Orthopaedic clinic.

PATIENTS OR OTHER PARTICIPANTS

Participants from a single orthopaedic practice who had undergone ACI within the previous 12 months were purposefully selected.

DATA COLLECTION AND ANALYSIS

Volunteers participated in 1-on-1 semistructured interviews to describe their recovery experiences after ACI. Data were analyzed using the process of horizontalization.

RESULTS

Seven patients (2 men, 5 women; age = 40.7 ± 7.5 years, time from surgery = 8.7 ± 4.2 months) participated. Four themes and 6 subthemes emerged from the data and suggested that the recovery process is a lengthy and emotional experience. Therapy provides optimism for the future but requires a collaborative effort among the patient, surgeon, rehabilitation provider, and patient's caregiver(s). Furthermore, patients expressed frustration that their expectations for recovery did not match the reality of the process, including greater dependence on caregivers than expected.

CONCLUSIONS

Patients' expectations should be elicited before surgery and managed throughout the recovery process. Providing preoperative patient and caregiver education and encouraging preoperative rehabilitation can assist in managing expectations. Establishing realistic goals and expectations may improve rehabilitation adherence, encourage optimism for recovery, and improve outcomes in the long term.

摘要

背景

由于存在明显的功能限制和较长的愈合时间,自体软骨细胞植入(ACI)后的恢复过程对患者和临床医生来说都具有挑战性。了解患者在恢复过程中的经历可能有助于临床医生提供更个性化的护理。

目的

探讨和描述ACI后恢复过程中患者的经历。

设计

定性研究。

地点

骨科诊所。

患者或其他参与者

从一家骨科诊所中,特意挑选出在过去12个月内接受过ACI的参与者。

数据收集与分析

志愿者参与一对一的半结构化访谈,以描述他们ACI后的恢复经历。使用水平化过程对数据进行分析。

结果

7名患者(2名男性,5名女性;年龄=40.7±7.5岁,手术时间=8.7±4.2个月)参与了研究。数据中出现了4个主题和6个子主题,表明恢复过程是一个漫长且充满情感的经历。治疗为未来带来了乐观的希望,但需要患者、外科医生、康复治疗师和患者照顾者之间的共同努力。此外,患者表示沮丧,因为他们对恢复的期望与实际过程不符,包括比预期更依赖照顾者。

结论

术前应了解患者的期望,并在整个恢复过程中进行管理。提供术前患者及照顾者教育并鼓励术前康复,有助于管理期望。设定现实的目标和期望可能会提高康复依从性,激发对恢复的乐观态度,并从长远来看改善治疗效果。

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