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围手术期护理期间患者的体验与需求:一项焦点小组研究

Patients' Experience and Needs During Perioperative Care: A Focus Group Study.

作者信息

Gobbo Milena, Saldaña Roberto, Rodríguez Marcos, Jiménez Javier, García-Vega María I, de Pedro José M, Cea-Calvo Luis

机构信息

Positivamente Psychology Center, Madrid, Spain.

Confederation of Patients with Crohn's Disease and Ulcerative Colitis, Madrid, Spain.

出版信息

Patient Prefer Adherence. 2020 May 27;14:891-902. doi: 10.2147/PPA.S252670. eCollection 2020.

Abstract

PURPOSE

Information regarding patients' needs, fears and experiences/perceptions in the perioperative setting is limited. Through two focus groups, we explored the needs, fears and experiences of patients who had recently undergone, or were scheduled for, surgery under general anaesthesia, with regard to the entire perioperative process.

MATERIALS AND METHODS

Adults were invited to participate in a focus group if they had (a) undergone abdominal or gynaecological surgery with general anaesthesia in the past 4 months (focus group 1) or (b) been indicated for abdominal or gynaecological surgery and were waiting for the assigned surgery date (focus group 2). Discussions were audio recorded and, through thematic analysis, patients' needs and experiences/perceptions regarding perioperative surgical stages were obtained/coded. Analysis of code co-occurrence was performed using a codes matrix.

RESULTS

Focus groups consisted of 13 females, 1 male (50% aged >45 years). The immediate postoperative period generated the highest number of co-occurrences, followed by the indication of surgery. The most frequent code was the need for information, especially at the indication of surgery, the pre-anaesthesia clinic and in the postoperative period. Fears were described particularly at the indication of surgery, the waiting period, the surgical room, anaesthesia induction and the postoperative period, particularly after hospital discharge; pain was cited most commonly in the postoperative period. Stress/anxiety and emotional impact were also cited in the postoperative period including home arrival.

CONCLUSION

Information collected in these patients' focus groups should inform future research and healthcare planning. Patients demand receiving more comprehensive and understandable information and more involvement in several steps; this could reduce fears and stress/anxiety described across the perioperative process. Importantly, findings also extend to the postoperative period and home arrival.

摘要

目的

关于患者在围手术期的需求、恐惧以及经历/认知的信息有限。通过两个焦点小组,我们探讨了近期接受全身麻醉手术或计划接受全身麻醉手术的患者在整个围手术期过程中的需求、恐惧和经历。

材料与方法

如果成年人(a)在过去4个月内接受过腹部或妇科全身麻醉手术(焦点小组1),或(b)被安排进行腹部或妇科手术且正在等待指定手术日期(焦点小组2),则邀请他们参加焦点小组。讨论进行了录音,并通过主题分析获取/编码了患者对围手术期手术阶段的需求和经历/认知。使用编码矩阵对编码共现进行分析。

结果

焦点小组由13名女性和1名男性组成(50%年龄>45岁)。术后即刻阶段出现的共现次数最多,其次是手术指征阶段。最常见的编码是对信息的需求,尤其是在手术指征阶段、麻醉前门诊和术后阶段。恐惧尤其在手术指征阶段、等待期、手术室、麻醉诱导期和术后阶段被提及,特别是在出院后;疼痛在术后阶段被提及最为普遍。压力/焦虑和情绪影响在术后阶段包括回家后也被提及。

结论

在这些患者焦点小组中收集的信息应为未来的研究和医疗保健规划提供参考。患者要求获得更全面、易懂的信息,并更多地参与几个步骤;这可以减少围手术期过程中描述的恐惧和压力/焦虑。重要的是,研究结果还延伸到术后阶段和回家后。

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