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患者和健康专业人员对影响急性肺栓塞后康复的重要因素的看法:一项多方法研究。

Perspectives of patients and health professionals on important factors influencing rehabilitation following acute pulmonary embolism: A multi-method study.

机构信息

Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark; DEFACTUM, Corporate Quality, Central Denmark Region, Aarhus, Denmark.

Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg, Denmark.

出版信息

Thromb Res. 2020 Dec;196:283-290. doi: 10.1016/j.thromres.2020.09.016. Epub 2020 Sep 13.

Abstract

BACKGROUND

International guidelines on pulmonary embolism (PE) management and rehabilitation have recently been published. However, the contained recommendation about an efficient follow-up strategy after PE is difficult for health care professionals to implement because limited research exists about what strategies are efficient.

OBJECTIVES

The study aimed to 1) describe and explore perspectives and experiences of health care professionals (HCPs) and patients participating in a post-PE rehabilitation intervention, and 2) provide suggestions for future post-PE management and rehabilitation interventions.

PATIENTS/METHODS: The study was a multi-method study, nested in a larger randomized controlled trial, combining data from two focus group interviews with 10 HCPs, 16 individual interviews with patients, data from exercise diaries and logbooks from HCPs participating in a rehabilitation intervention.

RESULTS

Key factors for successful post-PE management, considered important for reducing anxiety and confusion by both patients and HCPs, were the presence of a multidisciplinary specialized team, initiation of management shortly after discharge, and having regular follow-ups, e.g. telephone consultations. In terms of rehabilitation, repeatedly testing physical performance, resuming exercise under the guidance and support of specialized personnel, and access to peer support, were considered important for increasing motivation and self-efficacy for engaging in physical activity again.

CONCLUSIONS

This study offers suggestions for key elements to include in post-PE management and rehabilitation interventions, as well as the structuring of care. However, research still needs to be undertaken before solid recommendations for the content and structure of successful post-PE management and rehabilitation can be given.

摘要

背景

最近发布了国际肺栓塞(PE)管理和康复指南。然而,由于关于有效的 PE 后随访策略的建议很少,医疗保健专业人员难以实施这些建议,因为关于哪些策略有效的研究有限。

目的

本研究旨在 1)描述和探讨参与 PE 后康复干预的医疗保健专业人员(HCPs)和患者的观点和经验,以及 2)为未来的 PE 后管理和康复干预提供建议。

患者/方法:该研究是一项多方法研究,嵌套在一项更大的随机对照试验中,结合了对 10 名 HCPs 的两次焦点小组访谈、16 名患者的个人访谈、HCPs 参与康复干预的运动日记和日志的数据。

结果

成功的 PE 后管理的关键因素,被认为可以减轻患者和 HCPs 的焦虑和困惑,包括多学科专业团队的存在、在出院后不久开始管理,以及定期随访,例如电话咨询。在康复方面,反复测试身体机能、在专业人员的指导和支持下恢复运动,以及获得同伴支持,被认为对于提高再次进行身体活动的动机和自我效能感很重要。

结论

本研究为 PE 后管理和康复干预以及护理结构提供了建议,但仍需要进行研究,才能为成功的 PE 后管理和康复的内容和结构提出可靠建议。

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