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脑卒中幸存者从医院到家庭的过渡体验。

Stroke survivors' experiences transitioning from hospital to home.

机构信息

College of Nursing, University of Colorado, Aurora, Colorado.

Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.

出版信息

J Clin Nurs. 2018 Nov;27(21-22):3979-3987. doi: 10.1111/jocn.14563. Epub 2018 Jul 30.

Abstract

AIMS AND OBJECTIVES

To investigate the experiences of ischaemic stroke survivors during the transitional period from the hospital through the first 4 weeks after discharge home.

BACKGROUND

Ischaemic stroke survivors describe the transition from hospital to home as an important time in their recovery and describe various physical and cognitive concerns early within the recovery period. Adequate transitional care interventions should be informed by such experiences.

DESIGN

This is a qualitative descriptive study.

METHOD

This study used semistructured telephone interviews and an inductive approach to enable thematic analysis of information from 31 persons experiencing an ischaemic stroke.

RESULTS

Five major themes emerged: (a) the shock of a stroke interrupting a normal day; (b) transition to an unfamiliar home; (c) uncertainty; (d) understanding a new sense of self; and (e) adjusting to a new sense of self. All participants articulated a need to cope with uncertainty and adjusting to a new sense of self. Ischaemic stroke survivors who experienced less uncertainty described that return to their prior daily routine, preventing another stroke, depended on a helpful support system including frequent follow-up and communication with healthcare professionals.

CONCLUSION

All ischaemic stroke survivors are at risk for complications during recovery, regardless of stroke severity. This study found that, even after experiencing minimal physical or cognitive symptoms, ischaemic stroke survivors can have difficulty adjusting to life after discharge.

RELEVANCE TO CLINICAL PRACTICE

Adjusting to life after a stroke during the first 4 weeks after discharge home is an in individualised experience. For the complex psychosocial and physical needs of ischaemic stroke survivors, nurses can play an important role beyond symptom management by fostering a dynamic relationship through individualised transitional care based on ischaemic stroke survivors experiences.

摘要

目的和目标

调查缺血性脑卒中幸存者从医院过渡到出院后 4 周期间的体验。

背景

缺血性脑卒中幸存者描述说,从医院到家庭的过渡是他们康复过程中的一个重要时期,并在康复早期描述了各种身体和认知方面的担忧。充分的过渡性护理干预措施应该基于这些经验。

设计

这是一项定性描述性研究。

方法

本研究采用半结构式电话访谈和归纳法,对 31 名经历缺血性脑卒中的患者进行了信息的主题分析。

结果

出现了五个主要主题:(a)中风打断正常生活的震惊;(b)过渡到不熟悉的家庭;(c)不确定性;(d)理解新的自我意识;(e)适应新的自我意识。所有参与者都表达了应对不确定性和适应新自我意识的需要。经历不确定性较少的缺血性脑卒中幸存者表示,恢复到以前的日常生活、防止再次中风,取决于一个有益的支持系统,包括与医疗保健专业人员的频繁随访和沟通。

结论

所有缺血性脑卒中幸存者在康复期间都有发生并发症的风险,无论中风严重程度如何。本研究发现,即使经历了最小的身体或认知症状,缺血性脑卒中幸存者在出院后也可能难以适应生活。

临床意义

在出院后 4 周内适应中风后的生活是一种个体化的体验。对于缺血性脑卒中幸存者复杂的心理社会和身体需求,护士可以通过基于缺血性脑卒中幸存者的经验提供个性化的过渡性护理,通过动态关系发挥重要作用,而不仅仅是管理症状。

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