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建立和维护脊髓损伤压力性损伤预防和治疗伙伴关系的挑战:卫生专业人员观点的定性研究。

Challenges to building and maintaining partnership in the prevention and treatment of pressure injuries in spinal cord injury: a qualitative study of health professionals' views.

机构信息

Department of Health Sciences and Health Policy, University of Lucerne and Swiss Paraplegic Research, Lucerne/Nottwil, Switzerland / Swiss Paraplegic Research, Nottwil, Switzerland.

Swiss Paraplegic Research | Swiss Paraplegic Research, Nottwil, Switzerland.

出版信息

Swiss Med Wkly. 2019 Jun 30;149:w20086. doi: 10.4414/smw.2019.20086. eCollection 2019 Jun 17.

Abstract

AIMS OF THE STUDY

The effective management of spinal cord injury (SCI) requires partnership between people with SCI and health professionals (HPs). This paper identifies HPs’ perceived challenges in building and maintaining this partnership, with a specific focus on how people with SCI and HPs collaborate in the prevention and treatment of pressure injuries (PIs) in SCI.

DESIGN

This study has a qualitative and explorative design. Data were collected through semi-structured interviews and analysed following the principles of thematic analysis.

POPULATION AND SETTING

The study population consisted of a purposive sample of HPs (n = 26) working in inpatient and outpatient care in Switzerland with experience in the care of people with SCI.

RESULTS

The analysis identified three main challenges: defining responsibilities and expectations, negotiating priorities and establishing and strengthening trust and respect. The HPs argue that the prevention of PIs and self-management are mainly the responsibility of the person with SCI. The HPs have, however, the responsibility to empower, guide, and support persons with SCI in self-management by educating and motivating them.

CONCLUSION

Building and maintaining a partnership with individuals with SCI to prevent and treat PIs is crucial, but it is not an easy task for HPs. Specific communication skills can help HPs and patients find personalised solutions that take into account the patients’ expertise and preferences. Additionally, the healthcare system must develop solutions that go beyond personal partnership to better integrate the prevention and treatment of PIs into the lifelong self-management of SCI. Assistive technologies, such as mobile technology, might help in this endeavour.

摘要

目的

脊髓损伤 (SCI) 的有效管理需要 SCI 患者和卫生专业人员 (HPs) 之间的合作。本文旨在确定 HPs 在建立和维持这种合作关系方面所面临的挑战,特别关注 SCI 患者和 HPs 如何在预防和治疗压力性损伤 (PI) 方面进行合作。

设计

本研究采用定性和探索性设计。通过半结构化访谈收集数据,并按照主题分析的原则进行分析。

人群和环境

研究人群由瑞士住院和门诊护理中具有 SCI 患者护理经验的 26 名 HPs 组成。

结果

分析确定了三个主要挑战:定义责任和期望、协商优先事项以及建立和加强信任和尊重。HPs 认为预防 PI 和自我管理主要是 SCI 患者的责任。然而,HPs 有责任通过教育和激励来增强、指导和支持 SCI 患者进行自我管理。

结论

与 SCI 患者建立和维持预防和治疗 PI 的伙伴关系至关重要,但对 HPs 来说并非易事。特定的沟通技巧可以帮助 HPs 和患者找到个性化的解决方案,考虑到患者的专业知识和偏好。此外,医疗保健系统必须制定超越个人合作的解决方案,将 PI 的预防和治疗更好地纳入 SCI 的终身自我管理中。辅助技术,如移动技术,可能有助于这一努力。

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