Gehrke-Beck Sabine, Bänfer Mareike, Schilling Nina, Schmidt Konrad, Gensichen Jochen, Heintze Christoph
GP, Charité Universitätsmedizin Berlin, Institute of General Practice, Berlin, Germany.
Physician, Charité Universitätsmedizin Berlin, Institute of General Practice, Berlin, Germany.
BJGP Open. 2017 Jan 9;1(1):bjgpopen17X100725. doi: 10.3399/bjgpopen17X100725.
Survivors of sepsis suffer from multiple critical disease sequelae when discharged to primary care. There is a lack of structured aftercare programmes and case managers may be helpful in caring for patients with chronic critical disease.
To gain insight into the functioning of a structured aftercare programme for post-sepsis patients in general practice.
DESIGN & SETTING: A qualitative study using semi-structured interviews with patients and GPs across Germany who participated in an randomised controlled trial of a structured aftercare programme for post-sepsis patients, which included patient education and case manager monitoring.
Qualitative interviews with 19 patients and 13 GPs were audiorecorded, transcribed verbatim, and analysed using qualitative content analysis.
Patients appreciated the information given in the patient education session, but some disliked it because it reminded them of their serious illness. GPs appreciated patient education because well-informed patients are more likely to participate in follow-up. Patients appreciated the case monitoring because it made them feel safer and more cared for and helped them reflect on their health issues. However, some patients felt uncomfortable with the regular questioning. GPs appreciated the case management programme because they received regular clinical information. However some GPs were wary of the clinical relevance of the information, the delegation of the patient to the nurse, and efficiency of time. Both patients and GPs requested more clinical support, such as easier access to psychotherapists.
In general, both patients and their GPs appreciated patient education and monitoring following sepsis. Patients' retrospections and worries about their serious illness need to be considered.
脓毒症幸存者出院后进入初级保健阶段时会面临多种严重的疾病后遗症。缺乏结构化的后续护理计划，而个案管理员可能有助于照顾患有慢性重症疾病的患者。
深入了解在全科医疗中针对脓毒症后患者的结构化后续护理计划的运作情况。
一项定性研究，通过对德国参与脓毒症后患者结构化后续护理计划随机对照试验的患者和全科医生进行半结构化访谈，该计划包括患者教育和个案管理员监测。
对19名患者和13名全科医生进行的定性访谈进行了录音、逐字转录，并使用定性内容分析法进行分析。
患者对患者教育环节提供的信息表示赞赏，但有些人不喜欢，因为这让他们想起自己的重病。全科医生赞赏患者教育，因为信息灵通的患者更有可能参与随访。患者赞赏个案监测，因为这让他们感到更安全、更受关怀，并帮助他们反思自己的健康问题。然而，一些患者对定期询问感到不舒服。全科医生赞赏个案管理计划，因为他们收到了定期的临床信息。然而，一些全科医生对信息的临床相关性、将患者委托给护士以及时间效率表示谨慎。患者和全科医生都要求更多的临床支持，例如更容易获得心理治疗师的帮助。
总体而言，患者及其全科医生都赞赏脓毒症后的患者教育和监测。需要考虑患者对重病的反思和担忧。
