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患者与护士对心脏康复计划中提供心理支持的看法:一项定性研究

Patients' and nurses' views on providing psychological support within cardiac rehabilitation programmes: a qualitative study.

作者信息

Turner Katrina M, Winder Rachel, Campbell John L, Richards David A, Gandhi Manish, Dickens Chris M, Richards Suzanne

机构信息

Population Health Sciences, University of Bristol, Bristol, UK.

The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), Bristol, UK.

出版信息

BMJ Open. 2017 Sep 1;7(9):e017510. doi: 10.1136/bmjopen-2017-017510.

Abstract

OBJECTIVE

To explore patients' and nurses' views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services.

DESIGN

In-depth interviews analysed thematically.

PARTICIPANTS

18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression.

SETTING

Cardiac services based in the South West of England and the East Midlands, UK.

RESULTS

Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients' accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual's mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads.

CONCLUSIONS

Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation.

TRIAL REGISTRATION NUMBER

ISCTRN34701576.

摘要

目的

探讨患者和护士对在心脏康复服务中提供心理护理的可行性和可接受性的看法。

设计

进行主题分析的深入访谈。

参与者

18名患者和7名心脏科护士,他们参与了一项由护士在心脏康复项目中为有抑郁症状的患者提供强化心理护理干预的试点试验(CADENCE)。

地点

英国英格兰西南部和东米德兰兹郡的心脏科服务机构。

结果

患者和护士认为心理支持是良好心脏康复的核心。患者的叙述突出了心脏事件对个人心理健康可能产生的重大且直接的不利影响。他们还表明,患者重视护士关注其身心健康,并认为这对他们的全面康复至关重要。护士致力于提供心理支持,认为这对患者有益,并主张在心脏康复项目而非并行的医疗服务中提供这种支持。然而,护士时间有限,发现在现有工作量内提供心理护理具有挑战性。

结论

患者和护士都高度重视在心脏康复项目中提供心理支持,但资源限制给实施带来了障碍。因此,应考虑不单纯依赖护士的替代提供形式,以使患者在心脏康复期间能够获得心理支持。

试验注册号

ISCTRN34701576。

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