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患者的康复体验:从重症监护病房到社区。

Patients' experiences of recovery: Beyond the intensive care unit and into the community.

机构信息

Marquette University, Milwaukee, WI, USA.

University of Wisconsin Milwaukee, Milwaukee, WI, USA.

出版信息

J Adv Nurs. 2021 Apr;77(4):1867-1877. doi: 10.1111/jan.14729. Epub 2020 Dec 21.

Abstract

AIMS

To understand barriers and facilitators of recovery for critical illness survivors', who are discharged home from the hospital and do not have access to dedicated outpatient care.

DESIGN

Multi-site descriptive study guided by interpretive phenomenology using semi-structured interviews.

METHODS

Interviews were conducted between December 2017 -July 2018. Eighteen participants were included. Data were collected from interview recordings, transcripts, field notes, and a retrospective chart review for sample demographics. Analysis was completed using Interpretive Phenomenological Analysis which provided a unique view of recovery through the survivors' personal experiences and perception of those experiences.

RESULTS

Participants encountered several barriers to their recovery; however, they were resilient and initiated ways to overcome these barriers and assist with their recovery. Facilitators of recovery experienced by survivors included seeking support from family and friends, lifestyle adaptations, and creative management of their multiple medical needs. Barriers included unmet needs experienced by survivors such as mental health issues, coordination of care, and spiritual needs. These unmet needs left participants feeling unsupported from healthcare providers during their recovery.

CONCLUSION

This study highlights important barriers and facilitators experienced by critical illness survivors during recovery that need be addressed by healthcare providers. New ways to support critical illness survivors, that can reach a broader population, must be developed and evaluated to support survivors during their recovery in the community.

IMPACT

This study addressed ICU survivors' barriers and facilitators to recovery. Participants encountered several barriers to recovery at home, such as physical, cognitive, psychosocial, financial, and transportation barriers, however, these survivors were also resilient and resourceful in the development of strategies to try to manage their recovery at home. These results will help healthcare providers develop interventions to better support ICU survivors in the community.

摘要

目的

了解从医院出院回家且无法获得专门门诊护理的危重病幸存者康复的障碍和促进因素。

设计

以解释现象学为指导的多地点描述性研究,采用半结构式访谈。

方法

访谈于 2017 年 12 月至 2018 年 7 月进行。共纳入 18 名参与者。数据来自访谈录音、记录、现场记录和样本人口统计学的回顾性图表审查。使用解释现象学分析完成分析,该分析通过幸存者的个人经历和对这些经历的看法,提供了对康复的独特见解。

结果

参与者在康复过程中遇到了一些障碍;但是,他们很有弹性,并主动寻找方法来克服这些障碍并帮助他们康复。幸存者康复的促进因素包括寻求家人和朋友的支持、生活方式的调整以及创造性地管理他们的多种医疗需求。幸存者经历的康复障碍包括未满足的需求,如心理健康问题、护理协调和精神需求。这些未满足的需求使参与者在康复过程中感到没有得到医疗保健提供者的支持。

结论

本研究强调了危重病幸存者在康复过程中经历的重要障碍和促进因素,需要医疗保健提供者解决。必须开发和评估新的方法来支持危重病幸存者,以覆盖更广泛的人群,以在社区中支持幸存者的康复。

影响

本研究探讨了 ICU 幸存者康复的障碍和促进因素。参与者在家中康复时遇到了一些障碍,如身体、认知、心理社会、财务和交通障碍,但这些幸存者也很有弹性,能够想出策略来管理自己的家庭康复。这些结果将帮助医疗保健提供者制定干预措施,以更好地在社区中支持 ICU 幸存者。

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