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[大疱性表皮松解症患儿的敷料材料:一项关于家长和患病儿童经历的定性研究]

[Dressing material in children with epidermolysis bullosa : A qualitative study on experiences of parents and affected children].

作者信息

Hartenstein-Pinter Almut, Hübner-Möhler Bettina, Zernikow Boris, Wager Julia

机构信息

Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Lehrstuhl für Kinderschmerztherapie und pädiatrische Palliativmedizin, Fakultät für Gesundheit, Department für Humanmedizin, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland.

出版信息

Schmerz. 2020 Apr;34(2):156-165. doi: 10.1007/s00482-019-00439-8.

Abstract

BACKGROUND

Epidermolysis bullosa (EB) is a rare genetic disease that soon becomes apparent after a child's birth. Mechanical stress in particular causes painful skin-blistering that potentially leads to numerous complications. Dressing materials fulfill important functions for children with EB: they help protect the skin, but create problems at the same time.

OBJECTIVE

The study focuses on the experiences with dressing materials among parents and affected children. The exploration of individual experiences and the presentation of successful strategies to deal with problems is intended to contribute to a better understanding of the advantages and disadvantages of different dressing materials.

MATERIALS AND METHOD

Following a qualitative research approach, eight semi-structured interviews were conducted with N = 13 persons. For analysis, a structured qualitative content analysis with an inductive/deductive approach for setting up the final categories was chosen.

RESULTS

The use of dressing materials in the context of a dressing change is a key issue for parents and affected children. Five main categories were identified: the child's individuality; problems of use; the adjustment process; parents' expertise; organization of materials. In a continuous process, parents acquire specific knowledge and skills that enable a good fit between the dressing materials and their child and contribute to their own handling confidence.

CONCLUSION

With their action-oriented expertise, parents can avoid additional skin damage caused during dressing changes. Here, the focus is on technical skills that lead to more comfort for the affected child and help parents to meet the challenge of dressing changes. Regarding the child's development, parents are continually confronted with new challenges and must adapt their old, or develop new, strategies.

摘要

背景

大疱性表皮松解症(EB)是一种罕见的遗传性疾病,在儿童出生后不久就会显现出来。特别是机械性压力会导致皮肤疼痛起泡,进而可能引发多种并发症。敷料对患有EB的儿童起着重要作用:它们有助于保护皮肤,但同时也会带来问题。

目的

本研究聚焦于家长和患病儿童使用敷料的经历。探索个人经历并展示应对问题的成功策略,旨在有助于更好地理解不同敷料的优缺点。

材料与方法

采用定性研究方法,对13人进行了8次半结构化访谈。在分析时,选择了一种结构化定性内容分析法,采用归纳/演绎法来确定最终类别。

结果

在换药过程中使用敷料是家长和患病儿童面临的关键问题。确定了五个主要类别:孩子的个性;使用问题;调整过程;家长的专业知识;材料的组织。在一个持续的过程中,家长获得了特定的知识和技能,使敷料与孩子相适配,并增强了他们自己的操作信心。

结论

凭借以行动为导向的专业知识,家长可以避免在换药过程中造成额外的皮肤损伤。这里,重点在于技术技能,这些技能能让患病儿童更舒适,并帮助家长应对换药的挑战。关于孩子的成长,家长不断面临新的挑战,必须调整旧策略或制定新策略。

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