Glyde Megan, Keane David, Dye Louise, Sutherland Ed
School of Psychology, University of Leeds, Leeds, UK.
St. James' Hospital, Renal Medicine, Renal Research, Leeds, UK.
J Ren Care. 2019 Jun;45(2):83-92. doi: 10.1111/jorc.12275. Epub 2019 Apr 1.
Person-centred care is increasingly promoted, empowering patients to become more involved in their treatment rather than being passive recipients of care (Barnes et al. 2013). Haemodialysis is typically required three times a week, with fluid management decision-making occurring at each treatment session (Ahmed et al. 2017). However, no research has yet explored how haemodialysis patients' perceptions of their fluid management may impact upon this decision-making.
This study sought to explore patients' perceptions of their fluid management.
DESIGN, PARTICIPANTS & APPROACH: Semi-structured interviews were conducted with 12 patients undergoing in-hospital haemodialysis treatment. These were digitally recorded one-to-one interviews to allow for verbatim transcription. The data was analysed by thematic analysis, generating thematic patterns across patients' experiences, control and knowledge of their fluid management.
Five themes were produced: determining who has the expertise, impediments affecting patients' lifestyle, additional difficulty of experiencing comorbidities, perceived quality of care, and establishing consistency.
Despite varied levels of patient participation in their treatment, overall there appears to be a limited understanding of specific areas of fluid management. The implications for further research and the development of shared-care are discussed.
以患者为中心的护理模式越来越受到推崇,它使患者能够更多地参与到自身治疗中,而不是被动地接受护理(巴恩斯等人,2013年)。血液透析通常每周需要进行三次,每次治疗时都要进行液体管理决策(艾哈迈德等人,2017年)。然而,尚未有研究探讨血液透析患者对其液体管理的认知如何影响这一决策过程。
本研究旨在探究患者对其液体管理的认知。
设计、参与者与方法:对12名正在接受住院血液透析治疗的患者进行了半结构化访谈。这些访谈采用一对一的数字录音方式,以便逐字转录。通过主题分析对数据进行分析,梳理出患者在液体管理方面的经历、控制情况及相关知识中的主题模式。
得出了五个主题:确定谁具备专业知识、影响患者生活方式的障碍、合并症带来的额外困难、感知到的护理质量以及建立一致性。
尽管患者参与治疗的程度各不相同,但总体而言,患者对液体管理特定领域的理解似乎有限。文中还讨论了对进一步研究和共享护理发展的启示。