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在希望与绝望之间:慢性阻塞性肺疾病患者及其家属与医疗服务提供者互动的经历——一项质性纵向研究

Between hope and hopelessness: COPD patients' and their family members' experiences of interacting with healthcare providers - a qualitative longitudinal study.

作者信息

Andersen Ingrid Charlotte, Thomsen Thora Grothe, Bruun Poul, Bødtger Uffe, Hounsgaard Lise

机构信息

Department of Clinical Research, OPEN, Odense Patient data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark.

Department of Medicine, Slagelse Hospital, Slagelse, Denmark.

出版信息

Scand J Caring Sci. 2018 Sep;32(3):1197-1206. doi: 10.1111/scs.12565. Epub 2018 Feb 15.

Abstract

BACKGROUND

Patient-family-healthcare provider interaction seems important for patients with chronic obstructive pulmonary disease (COPD) and their family members' self-management practices. Because the need for support might be enhanced after a hospitalisation, it might be beneficial to explore this interaction further in follow-up health care.

AIM

To explore the meaning of patients' and their family members' experiences of interacting with healthcare providers to their daily self-management over time.

METHODS

Participant observations and in-depth interviews were conducted repeatedly with 10 patients and seven family members during follow-up visits at hospital and at the participants' homes between 2014 and 2016. A phenomenological-hermeneutical approach was used to interpret the data.

RESULTS

'Between hope and hopelessness' involved frustrations, concerns and doubts, all of which could relate to the interaction with healthcare providers. 'Seeking support from healthcare services', 'navigating between healthcare providers' and 'collaborating with healthcare providers at home' could entail opportunities to strengthen self-management and hope; however, it could also entail reduced faith in getting the right help and hopelessness.

CONCLUSION

During a period of transition after hospitalisation, available and well-coordinated healthcare services, and alliances with healthcare professionals are crucial to COPD patients and their family members in terms of their self-management, hope and well-being.

摘要

背景

患者-家属-医疗服务提供者之间的互动对于慢性阻塞性肺疾病(COPD)患者及其家属的自我管理实践似乎很重要。由于住院后对支持的需求可能会增加,因此在后续医疗保健中进一步探索这种互动可能会有所帮助。

目的

探讨患者及其家属与医疗服务提供者互动的经历对其日常自我管理的意义随时间的变化。

方法

2014年至2016年期间,在医院随访和参与者家中,对10名患者和7名家属进行了反复的参与观察和深入访谈。采用现象学-诠释学方法对数据进行解读。

结果

“在希望与绝望之间”涉及挫折、担忧和疑虑,所有这些都可能与与医疗服务提供者的互动有关。“寻求医疗服务支持”“在医疗服务提供者之间周旋”以及“在家中与医疗服务提供者合作”可能带来加强自我管理和增强希望的机会;然而,这也可能导致对获得正确帮助的信心降低和绝望感。

结论

在住院后的过渡期间,可用且协调良好的医疗服务以及与医疗专业人员的联盟对于COPD患者及其家属的自我管理、希望和幸福感至关重要。

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