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照顾者试图读懂严重脑损伤儿童细微动作的体验:一项现象学研究。

Caregivers' lived experience in trying to read slight movements in a child with severe brain injury: A phenomenological study.

机构信息

Setsunan University, Hirakata City, Osaka, Japan.

Kyoto University, Kyoto, Japan.

出版信息

J Clin Nurs. 2018 Mar;27(5-6):e1202-e1213. doi: 10.1111/jocn.14255. Epub 2018 Jan 23.

Abstract

AIMS AND OBJECTIVES

To explore caregivers' lived experience of reading slight movements of a child with severe brain injury.

BACKGROUND

Despite increased need, the development of individual care for children with severe brain injuries has been prevented by their severe physical state and the poor reproducibility of their movements. In addition to a lack of evidence on the motor characteristics of patients with severe brain injury with multiple disabilities, their own development contributes to increasing variability in their states. Thus, caregivers are compelled to rely on their experiences, which have not been academically explored.

DESIGN

A qualitative study based on van Manen's method of hermeneutic phenomenology.

METHODS

Data were obtained through twenty-one 3-hr observation sessions and five 15- to 45-min group interviews. We observed a child (called AK) with severe brain injury and his 61 caregivers, and conducted group interviews with 28 caregivers. We focused on caregivers' experiences of reading AK's slight movements. The data were interpreted based on van Manen's hermeneutic phenomenological approach.

RESULTS

Four themes emerged as caregivers' experience in trying to read AK's slight movements. By considering "AK's physical state and his slight movements" and discovering "caregivers' 'sense of uncertainty' about AK's slight movements," caregivers could decipher "AK's multiple slight movements." "Sharing" was found as a necessary aspect of these other three themes of reading AK's slight movements.

CONCLUSIONS

We presented caregivers' experiences as related to these four themes in their efforts to read the slight movements of AK. Due to AK's slight movements with poor reproducibility, "sharing" was necessary to read AK's slight movements, as it exposes caregivers' lived experience to the interpretation of multiple caregivers.

RELEVANCE TO CLINICAL PRACTICE

These four themes may be useful for assessing, guiding and promoting caregivers' use of sharing when reading the slight movements of children with severe brain injury.

摘要

目的和目标

探索照顾者阅读严重脑损伤儿童细微运动的体验。

背景

尽管需求增加,但由于儿童身体状况严重且运动重复性差,严重脑损伤儿童的个体化护理发展受到阻碍。此外,由于缺乏关于多重残疾严重脑损伤患者运动特征的证据,他们自身的发展也导致其状态的可变性增加。因此,照顾者不得不依赖他们的经验,但这些经验尚未在学术上得到探索。

设计

基于范梅南的解释现象学方法的定性研究。

方法

通过 21 次 3 小时的观察和 5 次 15-45 分钟的小组访谈获得数据。我们观察了一名患有严重脑损伤的儿童(称为 AK)及其 61 名照顾者,并对 28 名照顾者进行了小组访谈。我们专注于照顾者阅读 AK 细微运动的体验。数据是根据范梅南的解释现象学方法进行解释的。

结果

当照顾者试图阅读 AK 的细微运动时,出现了四个主题。通过考虑“AK 的身体状况和他的细微运动”,并发现“照顾者对 AK 的细微运动感到不确定”,照顾者可以解读“AK 的多重细微运动”。“分享”被发现是阅读 AK 细微运动的其他三个主题的必要方面。

结论

我们呈现了照顾者在努力阅读 AK 细微运动时与这四个主题相关的体验。由于 AK 的细微运动重复性差,“分享”对于阅读 AK 的细微运动是必要的,因为它使照顾者的生活经验暴露在多个照顾者的解释之下。

临床相关性

这四个主题可能有助于评估、指导和促进照顾者在阅读严重脑损伤儿童细微运动时的分享使用。

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