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创伤性脑损伤康复领域患者的就医体验:一项定性主题分析

Patient perspectives on navigating the field of traumatic brain injury rehabilitation: a qualitative thematic analysis.

作者信息

Graff Heidi J, Christensen Ulla, Poulsen Ingrid, Egerod Ingrid

机构信息

a Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet , University of Copenhagen , Copenhagen , Denmark.

b Trauma Center and Acute Admission, Rigshospitalet , University of Copenhagen , Copenhagen , Denmark.

出版信息

Disabil Rehabil. 2018 Apr;40(8):926-934. doi: 10.1080/09638288.2017.1280542. Epub 2017 Jan 27.

DOI:10.1080/09638288.2017.1280542
PMID:28129694
Abstract

PURPOSE

This study aimed to provide an understanding of the lived experience of rehabilitation in adults with traumatic brain injury (TBI) from hospital discharge up to four years post-injury.

MATERIALS AND METHODS

We used a qualitative explorative design with semi-structured in-depth interviews. Twenty participants with TBI were included from a level I Trauma Center in Denmark at 1-4 years post-injury. Qualitative thematic analysis was applied for data analysis.

RESULTS

Three main themes emerged during analysis: A new life, Family involvement, and Rehabilitation impediments. These themes and their sub-themes described the patient perspective of TBI and rehabilitation post hospitalization. Participants reassessed their values and found a new life after TBI. Family caregivers negotiated rehabilitation services and helped the participant to overcome barriers to rehabilitation. Although participants were entitled to TBI rehabilitation, they had to fight for the services they were entitled to.

CONCLUSION

Individuals with TBI found ways of coping after injury and created a meaningful life. Barriers to TBI rehabilitation were overcome with help from family caregivers rather than health care professionals. Future studies need to find ways to ease the burden on family caregivers and pave the way for more accessible rehabilitation in this vulnerable group of patients. Implications for rehabilitation TBI rehabilitation might benefit from:    • Increased transparency in rehabilitation options    • More systematic follow-up programs    • Age-appropriate rehabilitation facilities    • Inclusion of patient and family in the planning of long-term rehabilitation.

摘要

目的

本研究旨在了解创伤性脑损伤(TBI)成人患者从出院到受伤后四年的康复生活体验。

材料与方法

我们采用定性探索性设计,进行半结构化深度访谈。从丹麦一家一级创伤中心纳入了20名受伤后1至4年的TBI患者。采用定性主题分析法进行数据分析。

结果

分析过程中出现了三个主要主题:新生活、家庭参与和康复障碍。这些主题及其子主题描述了TBI患者及其住院后康复的观点。参与者重新评估了自己的价值观,并在TBI后找到了新生活。家庭照顾者协商康复服务,并帮助参与者克服康复障碍。尽管参与者有权接受TBI康复治疗,但他们必须为自己有权获得的服务而争取。

结论

TBI患者在受伤后找到了应对方法,并创造了有意义的生活。TBI康复的障碍是在家庭照顾者而非医护人员的帮助下克服的。未来的研究需要找到减轻家庭照顾者负担的方法,并为这一弱势群体提供更便捷的康复铺平道路。对康复的启示TBI康复可能受益于:

• 提高康复选择的透明度

• 更系统的随访计划

• 适合年龄的康复设施

• 将患者及其家庭纳入长期康复计划。

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