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赋能给谁?髋关节骨折管理中系统提供与患者需求之间的差距:医疗保健专业人员的生活世界视角。

Empowerment of whom? The gap between what the system provides and patient needs in hip fracture management: A healthcare professionals' lifeworld perspective.

机构信息

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

出版信息

Int J Orthop Trauma Nurs. 2020 Aug;38:100778. doi: 10.1016/j.ijotn.2020.100778. Epub 2020 Mar 25.

DOI:10.1016/j.ijotn.2020.100778
PMID:32595058
Abstract

AIMS AND OBJECTIVES

To use a Habermasian lifeworld theoretical perspective to illuminate a treatment gap for hip fracture patients in a Danish university hospital to guide future healthcare services.

BACKGROUND

Most healthcare systems focus on systematised guidelines to help reduce hospital length of stay in response to increasing demand because of the ageing of the global population. For patients with hip fractures, a previous study demonstrated that there is a lack of patient empowerment and a gap between patients' needs and wishes and what was provided by the healthcare system.

DESIGN

In this follow-up study, the previous findings were introduced to a mixed group of health professionals (HPs) who participated in focus group discussions (n = 3, with a total of 18 HPs).

METHODS

Data were analysed using qualitative content analysis. By analysing the discourse of the discussions using Habermas' perspective, the lack of patient-empowerment was illuminated and facilitated, describing it in terms of the gap it creates in communicative actions between HPs and patients.

RESULTS

Information and education of patients in systematised pathways, such as those for patients with hip fractures, are dominated by a biomedical discourse. Patients are overwhelmed by the psycho-social implications of the hip fracture, leaving them in a shock-like state of mind.

CONCLUSION

Empowerment of patients should involve empowerment of HPs by providing them with skills to support patients in a shock-like state of mind. There is also a need to provide HPs with a more individually targeted means of informing and educating patients.

摘要

目的和目标

运用哈贝马斯的生活世界理论视角,阐明丹麦大学医院髋部骨折患者的治疗差距,以指导未来的医疗保健服务。

背景

大多数医疗保健系统都侧重于系统的指南,以帮助减少因全球人口老龄化而导致的住院时间延长。对于髋部骨折患者,先前的研究表明,患者的赋权不足,患者的需求和愿望与医疗保健系统提供的之间存在差距。

设计

在这项后续研究中,将先前的研究结果介绍给一组混合的卫生专业人员(HPs),他们参加了焦点小组讨论(n=3,共有 18 名 HPs)。

方法

使用定性内容分析对数据进行分析。通过使用哈贝马斯的视角分析讨论的话语,阐明并促进了缺乏患者赋权的问题,并用其在卫生保健专业人员和患者之间的沟通行为中造成的差距来描述。

结果

在系统化的路径(如髋部骨折患者的路径)中对患者进行信息和教育,主要由生物医学话语主导。患者被髋部骨折的心理社会影响所淹没,使他们处于类似震惊的心理状态。

结论

赋予患者权力应包括通过提供支持处于类似震惊状态的患者的技能来赋予卫生保健专业人员权力。还需要为卫生保健专业人员提供更具针对性的告知和教育患者的手段。

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