Helse Fonna HF, Haugesund, Norway.
Western Norway University of Applied Sciences, Haugesund, Norway.
Scand J Caring Sci. 2020 Jun;34(2):409-419. doi: 10.1111/scs.12742. Epub 2019 Sep 5.
In Norway, 6000 patients were operated on due to hip fracture in 2016. Hip fracture results in increased suffering and often in a dramatic change in an older person's life. The experience of suffering in patients with hip fracture, or nursing staff's perception of it in the preoperative period, is sparsely studied. The perspective of the study was based on caring sciences.
The aim of this study was to gain a deeper understanding of subjective experiences of suffering among elderly hip-fracture patients during the preoperative period, seen from the patients' and nurses' perspective.
A Q-methodological approach was used. Forty statements (Q-sample), based on interviews and theory, were ranked in a forced-choice distribution curve from 'mostly agree' to 'mostly disagree', followed by postinterviews. Nine patients and five nurses participated. A by-person factor analysis in the form of principal component analysis with varimax and hand rotation was conducted.
Three factors, also called viewpoints, emerged as follows: (i) 'Feeling safe through presence, trust and hope'; (ii) 'Feeling safe occurs when the patient is seen, met and informed'; and (iii) 'Feeling alone and angry at oneself'. A polarisation between participants occurred, since the youngest patients (median age 73), the oldest patients (median age 90) and the nurses were represented in each specific factor.
There exist differences between how the nursing staff, the youngest and the oldest elderly patients experienced the preoperative period and what can enhance or alleviate their suffering. Where the youngest elderly communicated safety through trust and relatives' presence, the oldest elderly communicated insecurity in relation to staff and experienced severe pain and loneliness. Nursing staff and one patient emphasised the importance of seeing the patient in the first meeting to establish a feeling of security.
2016 年，挪威有 6000 名髋部骨折患者接受了手术。髋部骨折会导致患者承受更多痛苦，通常会使老年人的生活发生巨大变化。对于髋部骨折患者的痛苦体验，或者术前护理人员对其的感知，研究甚少。本研究的视角基于关怀科学。
本研究旨在深入了解老年髋部骨折患者在术前期间的主观痛苦体验，从患者和护士的角度来看。
采用 Q 方法学方法。基于访谈和理论，设计了 40 个陈述（Q 样本），并在强制选择分布曲线上从“非常同意”到“非常不同意”进行排序，随后进行了访谈。共有 9 名患者和 5 名护士参与了研究。采用主成分分析与方差极大和手动旋转的个人因素分析法进行分析。
出现了三个因素，也称为观点：（i）“通过存在、信任和希望感到安全”；（ii）“当患者被看到、被接触并被告知时，就会感到安全”；（iii）“感到孤独和自责”。参与者之间出现了两极分化，因为最年轻的患者（中位数年龄 73 岁）、最年长的患者（中位数年龄 90 岁）和护士都代表了每个特定的因素。
护理人员、最年轻和最年长的老年患者对术前期间的体验以及可以增强或减轻他们痛苦的因素存在差异。最年轻的老年患者通过信任和亲属的存在来传达安全感，而最年长的老年患者则在与医护人员的关系中感到不安，并经历了严重的疼痛和孤独感。护理人员和一名患者强调了在初次见面时看到患者的重要性，以建立安全感。
