探讨慢性阻塞性肺疾病患者从肺康复到家庭护理的过渡：一项描述性定性研究。
Exploring transitions in care from pulmonary rehabilitation to home for persons with chronic obstructive pulmonary disease: A descriptive qualitative study.
机构信息
Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
Department of Respiratory Medicine, West Park Healthcare Centre, York, ON, Canada.
出版信息
Health Expect. 2020 Apr;23(2):414-422. doi: 10.1111/hex.13012. Epub 2020 Jan 1.
BACKGROUND
Individuals with chronic obstructive pulmonary disease (COPD) often experience high health-care utilization following pulmonary rehabilitation, suggesting suboptimal transitions to home.
OBJECTIVE
To understand the experiences of persons with COPD and health-care professionals regarding transitions from pulmonary rehabilitation to home, including factors impacting these transitions.
DESIGN
A descriptive qualitative study.
SETTING AND PARTICIPANTS
Health-care professionals working at, and persons with COPD who attended, an inpatient or outpatient pulmonary rehabilitation programme at one large, urban health-care centre. The centre is located in Ontario, Canada.
MAIN VARIABLE STUDIED
Experiences of participants with care transitions between pulmonary rehabilitation and home. Semi-structured interviews were audio-recorded, transcribed verbatim, and thematically analysed.
RESULTS
Ten patients and eight health-care professionals participated. Four main themes were identified around the overall experiences with pulmonary rehabilitation and transitions to home: (a) pulmonary rehabilitation as a safe environment; (b) pulmonary rehabilitation as a highly structured environment; (c) contrasting perceptions of the role of pulmonary rehabilitation; and (d) dependency on pulmonary rehabilitation programmes. Persons with COPD and health-care professionals identified three key factors that influenced this transition: (a) patients' social support, (b) application of self-management strategies prior to discharge, and (c) patients' physical and mental health.
CONCLUSION
Participants agreed that some patients with COPD experienced suboptimal transitions from pulmonary rehabilitation to home that were characterized by suboptimal self-management. Further research is needed to develop and evaluate interventions to improve transitions. Such interventions should include strategies to elicit long-term behaviour change to assist patients when they return into the community.
背景
慢性阻塞性肺疾病（COPD）患者在肺康复后经常经历高医疗保健利用率，这表明向家庭的过渡并不理想。
目的
了解 COPD 患者和医疗保健专业人员对从肺康复到家庭过渡的经验，包括影响这些过渡的因素。
设计
描述性定性研究。
地点和参与者
在一家大型城市医疗中心的住院或门诊肺康复计划中工作的医疗保健专业人员，以及参加该计划的 COPD 患者。该中心位于加拿大安大略省。
主要研究变量
参与者在肺康复和家庭之间的护理过渡的经验。对参与者进行半结构化访谈，对访谈进行录音、逐字转录，并进行主题分析。
结果
有 10 名患者和 8 名医疗保健专业人员参与了研究。围绕着肺康复和家庭过渡的总体经验，确定了四个主要主题：（a）肺康复是一个安全的环境；（b）肺康复是一个高度结构化的环境；（c）对肺康复作用的看法不同；（d）对肺康复计划的依赖。COPD 患者和医疗保健专业人员确定了影响这一过渡的三个关键因素：（a）患者的社会支持；（b）在出院前应用自我管理策略；（c）患者的身心健康。
结论
参与者一致认为，一些 COPD 患者从肺康复向家庭的过渡并不理想，其特点是自我管理不佳。需要进一步研究以开发和评估干预措施，以改善过渡。这些干预措施应包括制定策略以激发长期行为改变，以帮助患者在返回社区时。
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