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重症监护病房幸存者护理的积极评价:一项定性二次分析

Positive Appraisal of Caregiving for Intensive Care Unit Survivors: A Qualitative Secondary Analysis.

作者信息

Tate Judith A, Choi JiYeon

机构信息

Judith A. Tate is an assistant professor at the Ohio State University College of Nursing, Columbus, Ohio.

JiYeon Choi is an assistant professor at Yonsei University College of Nursing, Mo-Im Kim Nursing Research Institute, Seoul, Korea. At the time of the study, Choi was at the University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania.

出版信息

Am J Crit Care. 2020 Sep 1;29(5):340-349. doi: 10.4037/ajcc2020953.

Abstract

BACKGROUND

More than half of intensive care unit survivors require assistance from family caregivers after discharge. Caregiving is associated with negative consequences including poor health-related quality of life, psychosocial distress, and burden. Little is known about how family caregivers find satisfaction and meaning in their experience.

OBJECTIVES

To explore positive descriptions of the experiences of family caregivers of critically ill patients and to describe factors that family caregivers view as important to a positive caregiving experience from hospitalization to 4 months after discharge.

METHODS

Qualitative secondary analysis was performed on data from semistructured interviews conducted as part of a longitudinal study that examined physical and psychological responses to stress in a convenience sample of family caregivers of adult intensive care unit patients who underwent prolonged mechanical ventilation (≥ 4 days). Interviews were conducted at 4 time points: during the hospitalization and within 2 weeks, 2 months, and 4 months after discharge.

RESULTS

Participants (n = 41) reported factors that helped them positively appraise their caregiving experience in 113 interviews conducted face to face or via telephone. During patients' hospitalization, caregivers described changes in their role, with their primary responsibility being to advocate for the patient. They described how this experience fulfilled their identity and strengthened their relationship with the patient. Most family caregivers mentioned the importance of social support and prayer.

CONCLUSIONS

Family caregivers of intensive care unit patients can identify positive aspects of caregiving during the experience. Interventions to reframe the caregiving experience in a positive light are warranted.

摘要

背景

超过半数的重症监护病房幸存者出院后需要家庭照顾者的帮助。照顾工作会带来一些负面后果,包括健康相关生活质量较差、心理社会困扰和负担。对于家庭照顾者如何在其经历中找到满足感和意义,人们知之甚少。

目的

探讨重症患者家庭照顾者经历的积极描述,并描述家庭照顾者认为从住院到出院后4个月期间积极照顾经历的重要因素。

方法

对作为纵向研究一部分进行的半结构化访谈数据进行定性二次分析,该纵向研究调查了接受长时间机械通气(≥4天)的成年重症监护病房患者的家庭照顾者便利样本对压力的身体和心理反应。在4个时间点进行访谈:住院期间以及出院后2周内、2个月和4个月。

结果

41名参与者在113次面对面或通过电话进行的访谈中报告了有助于他们积极评价照顾经历的因素。在患者住院期间,照顾者描述了他们角色的变化,其主要责任是为患者争取权益。他们描述了这段经历如何实现了他们的身份认同并加强了他们与患者的关系。大多数家庭照顾者提到了社会支持和祈祷的重要性。

结论

重症监护病房患者的家庭照顾者能够识别照顾经历中的积极方面。有必要采取干预措施,以积极的视角重新构建照顾经历。

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