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通往新稳定状态的旅程——从日间手术角度看术后恢复概念的进一步发展:一项定性研究

A journey to a new stable state-further development of the postoperative recovery concept from day surgical perspective: a qualitative study.

作者信息

Nilsson Ulrica, Jaensson Maria, Hugelius Karin, Arakelian Erebouni, Dahlberg Karuna

机构信息

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

Perioperative Medicine and Intensive Care, Karolinska Universitetssjukhuset, Stockholm, Sweden.

出版信息

BMJ Open. 2020 Sep 23;10(9):e037755. doi: 10.1136/bmjopen-2020-037755.

Abstract

OBJECTIVE

This study aims to further develop the concept analysis by Allvin in 2007 and Lundmark in 2016 from the perspective of day-surgery patients. Also, to describe how patients experience postoperative recovery in relation to the identified dimensions and subdimensions and to interpret the findings in order to get a deeper understanding of the concept postoperative recovery.

DESIGN

Descriptive qualitative design with a theoretical thematic analysis.

SETTING

Six day-surgery departments in Sweden.

PARTICIPANTS

Thirty-eight adult participants who had undergone day surgery in Sweden. Participants were purposively selected.

RESULTS

Four dimensions-physical, psychological, social and habitual-were confirmed. A total of eight subdimensions were also confirmed, two from Allvin 's study and six from Lundmark 's study. Recovery included physical symptoms and challenges coping with and regaining control over symptoms and bodily functions. Both positive and negative emotions were present, and strategies on how to handle emotions and achieve well-being were established. Patients became dependent on others. They coped with and adapted to the recovery process and gradually stabilised, reaching a new stable state.

CONCLUSION

Postoperative recovery was described as a process with a clear starting point, and as a dynamic and individual process leading to an experience of a new stable state. The recovery process included physical symptoms, emotions and social and habitual consequences that challenges them. To follow-up and measure all four dimensions of postoperative recovery in order to support and understand the process of postoperative recovery is, therefore, recommended.

摘要

目的

本研究旨在从日间手术患者的角度进一步拓展阿尔文在2007年以及伦德马克在2016年所进行的概念分析。此外,描述患者如何根据所确定的维度和子维度体验术后恢复情况,并对研究结果进行解读,以便更深入地理解术后恢复这一概念。

设计

采用理论主题分析的描述性定性设计。

背景

瑞典的六个日间手术科室。

参与者

38名在瑞典接受日间手术的成年参与者。参与者是经过有目的地挑选的。

结果

确认了四个维度——身体、心理、社会和习惯维度。总共还确认了八个子维度,其中两个来自阿尔文的研究,六个来自伦德马克的研究。恢复包括身体症状以及应对和重新掌控症状及身体功能方面的挑战。既有积极情绪也有消极情绪,并且确立了如何处理情绪和实现幸福感的策略。患者变得依赖他人。他们应对并适应恢复过程,逐渐稳定下来,达到一种新的稳定状态。

结论

术后恢复被描述为一个有明确起点的过程,是一个动态的、因人而异的过程,最终会带来一种新的稳定状态的体验。恢复过程包括身体症状、情绪以及对他们构成挑战的社会和习惯方面的后果。因此,建议对术后恢复的所有四个维度进行随访和测量,以支持和理解术后恢复过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a32/7513634/a07c0d668c86/bmjopen-2020-037755f01.jpg

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