Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus N, Denmark.
Department of Clinical Medicine, Centre of Research in Rehabilitation (CORIR), Aarhus University, Aarhus N, Denmark.
J Clin Nurs. 2018 Nov;27(21-22):4112-4118. doi: 10.1111/jocn.14560. Epub 2018 Aug 1.
To explore patients' experiences of acute dyspnoea, physical functioning and perspectives on course of illness prior to admission to the emergency department.
Many emergency admissions are considered unnecessary and avoidable. In this perspective, it seems relevant to gain insight into the patients' perspective on acute dyspnoea and the need for emergency admission. However, only few studies have investigated reasons for emergency admission from a patient perspective.
A qualitative study was conducted with semi-structured interviews among six patients previously admitted to the emergency department due to dyspnoea. Data collection and analysis were carried out according to Kvale & Brinkmann using meaning condensation.
Dyspnoea was experienced as an unpleasant breathlessness in the form of pain or suffocation, which limited usual physical activities, negatively impacting on quality of life. Self-management strategies such as medication, breathing exercises, distraction from breathing, and mental and physical relaxation in general were used to avoid hospital admission. The chronically ill patients saw the following ways to alternate course of disease to avoid admissions to the emergency department: easier access to specialised emergency medical care, medical supplies in the patient's home and making existing physical exercise programmes more accessible and interesting.
It would be relevant to further investigate whether prehospital interventions may remedy acute dyspnoea among chronically ill patients, and whether such interventions are cost-effective.
探索患者在急诊科入院前急性呼吸困难、身体功能和疾病过程的看法。
许多急诊入院被认为是不必要和可以避免的。从这个角度来看,了解患者对急性呼吸困难和急诊入院需求的看法似乎很重要。然而,只有少数研究从患者的角度调查了急诊入院的原因。
这是一项定性研究,对因呼吸困难而先前被急诊科收治的 6 名患者进行了半结构化访谈。数据收集和分析是根据 Kvale 和 Brinkmann 使用意义凝结进行的。
呼吸困难被体验为一种不愉快的呼吸困难,表现为疼痛或窒息感,限制了通常的身体活动,对生活质量产生负面影响。自我管理策略,如药物治疗、呼吸练习、分散呼吸注意力以及一般的心理和身体放松,被用来避免住院。慢性疾病患者看到了以下方法来改变疾病过程,以避免急诊科入院:更容易获得专门的急诊医疗护理、在患者家中的医疗用品,以及使现有的体育锻炼计划更容易获得和更有趣。
进一步研究院前干预措施是否可以缓解慢性疾病患者的急性呼吸困难,以及这种干预措施是否具有成本效益,这将是相关的。