对医疗保健障碍和支持的潜在内容分析：来自患有与军事相关的创伤性脑损伤的军人和退伍军人的护理人员的观点。
A Latent Content Analysis of Barriers and Supports to Healthcare: Perspectives From Caregivers of Service Members and Veterans With Military-Related Traumatic Brain Injury.
机构信息
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor (Drs Carlozzi and Ms Freedman); Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, and National Intrepid Center of Excellence (Drs Lange, French, and Brickell), Bethesda, Maryland; University of British Columbia, Vancouver, Canada (Dr Lange); Uniformed Services University of the Health Sciences, Bethesda, Maryland (Drs French and Brickell); Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland (Dr French); and TIRR Memorial Hermann, Brain Injury Research Center, and Baylor College of Medicine & Harris Health System (Dr Sander), Houston, Texas.
出版信息
J Head Trauma Rehabil. 2018 Sep/Oct;33(5):342-353. doi: 10.1097/HTR.0000000000000373.
OBJECTIVE
To identify barriers and supports that caregivers of individuals with military-related traumatic brain injury (TBI) encounter when navigating the military healthcare system; this information will be used as the foundation of a new patient-reported outcome measure.
SETTING
Community.
PARTICIPANTS
Forty-five caregivers of service members and veterans (SMV) who sustained a medically documented mild, moderate, severe, or penetrating TBI.
DESIGN
Latent content analysis.
MAIN MEASURES
Nine focus group discussions of barriers and supports to navigating the military healthcare system and community resources.
RESULTS
Latent content analysis indicated that caregivers discussed barriers (66%) and supports (34%) to obtaining care within the military healthcare system and the community. Caregivers most frequently discussed SMVs' interactions with healthcare, their own interactions with healthcare, family care, and community organizations.
CONCLUSIONS
Caregivers confront numerous challenges while pursuing healthcare services. Although much of the discussion focused on barriers and perceived unmet needs within the military healthcare system, caregivers also recognized supports within the military healthcare system and general community. Increased attention to accessibility and quality of services, as well as reducing financial burden, can lead to improved health-related quality of life for caregivers and their SMVs.
目的
确定照顾有军事相关创伤性脑损伤（TBI）的个人的照顾者在使用军事医疗保健系统时遇到的障碍和支持；这些信息将作为新的患者报告结果测量的基础。
地点
社区。
参与者
45 名照顾现役军人和退伍军人（SMV）的人员，他们曾有过医学记录的轻度、中度、重度或穿透性 TBI。
设计
潜在内容分析。
主要措施
9 个焦点小组讨论了在军事医疗保健系统和社区资源中导航的障碍和支持。
结果
潜在内容分析表明，照顾者讨论了在军事医疗保健系统和社区中获得护理的障碍（66%）和支持（34%）。照顾者最常讨论的是 SMV 与医疗保健的互动、他们自己与医疗保健的互动、家庭护理和社区组织。
结论
照顾者在寻求医疗服务时面临着许多挑战。尽管大部分讨论都集中在军事医疗保健系统内的障碍和感知到的未满足需求上，但照顾者也认识到了军事医疗保健系统和一般社区内的支持。更多关注服务的可及性和质量，以及减轻经济负担，可以提高照顾者及其 SMV 的与健康相关的生活质量。
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