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定义危重病后以患者为中心的康复 - 一项定性研究。

Defining patient-centered recovery after critical illness - A qualitative study.

机构信息

University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.

University Hospital Geelong, Barwon Health, Geelong, VIC, Australia; School of Medicine, Deakin University, Geelong, VIC, Australia.

出版信息

J Crit Care. 2020 Jun;57:84-90. doi: 10.1016/j.jcrc.2020.01.028. Epub 2020 Feb 6.

Abstract

PURPOSE

To explore perspectives of adult critical illness survivors and identify important aspects to care and recovery.

MATERIALS AND METHODS

A descriptive, qualitative study of adult survivors of prolonged critical illness, six-months after Intensive Care Unit (ICU) discharge, using semi-structured interviews and thematic analysis. The study was undertaken in an academic, tertiary, regional hospital in Victoria, Australia.

RESULTS

Thirty-five patients participated in the study. Most were male (69%) with median age 64 years. Admissions were predominantly medical (51%), followed by cardiothoracic (26%) and general surgical (23%). Median ICU and hospital length of stay were 5 and 17 days respectively. Qualitative analysis revealed two key theme categories, recovery status and care experience. Three recovery states were identified based on physical and neuropsychological recovery. Care experiences varied across recovery states, including care encounters, communication, support and impact on family and friends, and use of community health services.

CONCLUSION

Critical illness survivors frame their recovery in terms of recovery status and care experience, reflecting existing qualitative domains of physical health, psychological health, cognitive function, social health and life satisfaction. Theme content varied with recovery status, raising the possibility that modifying care experiences or patient perceptions could change recovery outcomes.

摘要

目的

探讨成人危重症幸存者的观点,并确定对其护理和康复至关重要的方面。

材料和方法

这是一项描述性、定性研究,对重症监护病房(ICU)出院后 6 个月的成人危重症幸存者进行研究,采用半结构化访谈和主题分析。该研究在澳大利亚维多利亚州的一所学术性、三级区域性医院进行。

结果

35 名患者参与了这项研究。大多数为男性(69%),中位年龄为 64 岁。入住 ICU 的主要原因是内科疾病(51%),其次是心胸外科(26%)和普通外科(23%)。中位 ICU 住院时间和总住院时间分别为 5 天和 17 天。定性分析揭示了两个关键主题类别,即恢复状况和护理体验。根据身体和神经心理学恢复情况,确定了三种恢复状态。恢复状态不同,护理体验也不同,包括护理接触、沟通、支持以及对家庭和朋友的影响,以及对社区卫生服务的利用。

结论

危重症幸存者根据恢复状况和护理体验来描述自己的恢复情况,反映了现有的身体、心理健康、认知功能、社会健康和生活满意度等定性领域。主题内容因恢复状况而异,这表明改变护理体验或患者认知可能会改变恢复结果。

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