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促进和阻碍社区中脊髓损伤患者支持的因素:家庭照顾者和照顾对象的经验。

Facilitators and barriers to supporting individuals with spinal cord injury in the community: experiences of family caregivers and care recipients.

机构信息

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.

Toronto Rehabilitation Institute, University Health Network Toronto, Canada.

出版信息

Disabil Rehabil. 2020 Jun;42(13):1844-1854. doi: 10.1080/09638288.2018.1541102. Epub 2019 Jan 23.

Abstract

Family members make an important contribution to informal and formal care, as well as the overall health and wellbeing of individuals with spinal cord injury. Caregiving often results in negative outcomes which, if not addressed, threaten the sustainability of these critical supports. We sought to explore the perceptions of individuals with spinal cord injury and their family caregivers regarding the facilitators and barriers to undertaking and sustaining the caregiving role in the community. A qualitative descriptive approach with semi-structured interviews. Thematic analysis was employed to determine key themes arising from individuals with spinal cord injury ( = 19) and their family members' ( = 16) experiences. The following four facilitators to caregiving were identified: access to community support services, positive coping in relationship, social support, and mastery of caregiving roles. Conversely, the following six barriers to caregiving were identified: lack of access to community resources, lack of knowledge about resources and formal training, fragmented continuity of care, negative coping in relationship, role strain, and caregiver injury or illness. The current study demonstrated that positive coping, social support, skills training, access to community services and continuity of care contribute significantly to the sustainability of the spinal cord injury family caregiving role. As such, the development of future caregiver interventions should consider these facilitators.Implications for RehabilitationFamily caregivers make an important contribution to the care processes and overall quality of life of individuals with spinal cord injury post-discharge into the community.The potential negative effects of caregiving could threaten the sustainability of these critical supports.Positive coping, social support, skills training, access to community services, and continuity of care contribute significantly to the sustainability of the spinal cord injury family caregiving role.This study shows the need for better integration of family members during the rehabilitation and discharge process to better prepare them for the caregiving role.

摘要

家庭成员为非正规和正规护理以及脊髓损伤患者的整体健康和福祉做出了重要贡献。照护往往会导致负面后果,如果不加以解决,这些关键支持的可持续性将受到威胁。我们旨在探讨脊髓损伤患者及其家庭成员对在社区中承担和维持照护角色的促进因素和障碍的看法。采用半结构式访谈的定性描述方法。采用主题分析确定了脊髓损伤患者(n=19)及其家庭成员(n=16)经验中出现的关键主题。确定了以下四个促进照护的因素:获得社区支持服务、积极应对关系、社会支持和掌握照护角色。相反,确定了以下六个照护障碍:无法获得社区资源、缺乏对资源和正规培训的了解、护理连续性中断、关系中消极应对、角色紧张和照顾者受伤或患病。本研究表明,积极应对、社会支持、技能培训、获得社区服务和护理连续性对脊髓损伤家庭照护角色的可持续性有重要贡献。因此,未来的护理人员干预措施应考虑这些促进因素。

康复意义

家庭照顾者为脊髓损伤患者出院后进入社区的护理过程和整体生活质量做出了重要贡献。

照护的潜在负面影响可能威胁到这些关键支持的可持续性。

积极应对、社会支持、技能培训、获得社区服务和护理连续性对脊髓损伤家庭照护角色的可持续性有重要贡献。

这项研究表明,在康复和出院过程中需要更好地整合家庭成员,以使他们更好地为照护角色做好准备。

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