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《独自在家的伤口》-静脉溃疡患者自行治疗溃疡的原因和方式:一项定性内容研究。

"Wounds Home Alone"-Why and How Venous Leg Ulcer Patients Self-Treat Their Ulcer: A Qualitative Content Study.

机构信息

Medical Faculty, Department of Family Medicine, University of Ljubljana, Poljanski nasip 58, Ljubljana 1000, Slovenia.

Study of Nursing, Bjelovar University of Applied Sciences, Trg. E.Kvaternika 4, Bjelovar 43000, Croatia.

出版信息

Int J Environ Res Public Health. 2019 Feb 15;16(4):559. doi: 10.3390/ijerph16040559.

Abstract

BACKGROUND

Venous leg ulcers (VLUs), the most common type of leg ulcerations, have long healing times and high recurrence rates; reimbursement rules and a general shortage of nursing staff have put self-treatment into focus. The study aimed to investigate why and how patients with VLUs self-treat their ulcers.

METHODS

Patients with VLUs ( = 32) were selected by criterion sampling for a multicentric qualitative study using semi-structured interviews. The interviews were analyzed via inductive qualitative content analysis.

RESULTS

More than two-thirds of participants sometimes self-treated VLU and one quarter changed their prescribed treatment. Experiences were expressed through four themes as follows: (a) current local VLU therapy; (b) VLU self-treatment; (c) patient education; and (d) psychosocial issues. The main reasons for self-treatment were a lack of healthcare resources, reimbursement restrictions, and dissatisfaction with conventional treatment together with insufficient knowledge about the wound-healing process and possible side effects. No educational materials were provided for patients or caregivers. Many patients adopted homemade remedies.

CONCLUSION

Patients with VLUs practice self-care due to limited healthcare availability, a low awareness of the causes of their condition, and the effects of therapy on VLU healing. Future educational intervention is needed to enhance self-treatment.

摘要

背景

静脉溃疡(VLUs)是最常见的腿部溃疡类型,其愈合时间长,复发率高;报销规则和护理人员普遍短缺使得自我治疗成为焦点。本研究旨在探讨患者为何以及如何自行治疗静脉溃疡。

方法

采用半结构式访谈,通过标准抽样法选择 32 名静脉溃疡患者进行多中心定性研究。使用归纳定性内容分析法对访谈进行分析。

结果

超过三分之二的参与者有时会自行治疗 VLU,四分之一的参与者会改变规定的治疗方法。通过四个主题表达了他们的经验:(a)当前局部 VLU 治疗;(b)VLU 自我治疗;(c)患者教育;和(d)心理社会问题。自行治疗的主要原因是医疗资源有限、报销限制、对常规治疗不满意以及对伤口愈合过程和可能的副作用了解不足。没有为患者或护理人员提供教育材料。许多患者采用了自制的治疗方法。

结论

静脉溃疡患者进行自我护理是由于医疗保健资源有限、对病情原因的认识不足以及治疗对静脉溃疡愈合的影响。未来需要进行教育干预以增强自我治疗。

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本文引用的文献

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Dressings and topical agents for treating venous leg ulcers.用于治疗下肢静脉溃疡的敷料和外用剂。
Cochrane Database Syst Rev. 2018 Jun 15;6(6):CD012583. doi: 10.1002/14651858.CD012583.pub2.
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How and why patients self-treat chronic wounds.患者如何以及为何自行治疗慢性伤口。
Int Wound J. 2017 Dec;14(6):1269-1275. doi: 10.1111/iwj.12796. Epub 2017 Aug 6.
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The quality of life of people who have chronic wounds and who self-treat.慢性病患自行治疗者的生活质量。
J Clin Nurs. 2018 Jan;27(1-2):182-192. doi: 10.1111/jocn.13870. Epub 2017 Aug 9.

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