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全科医生在脓毒症患者护理方面的观点和经验:一项定性访谈研究。

General practitioners' views and experiences in caring for patients after sepsis: a qualitative interview study.

机构信息

Institute of General Practice and Family Medicine, Charite University Medicine Berlin, Berlin, Germany.

Institute of General Practice and Family Medicine, University Hospital Munich, Munchen, Germany.

出版信息

BMJ Open. 2021 Feb 10;11(2):e040533. doi: 10.1136/bmjopen-2020-040533.

Abstract

BACKGROUND

Patients surviving critical illnesses, such as sepsis, often suffer from long-term complications. After discharge from hospital, most patients are treated in primary care. Little is known how general practitioners (GPs) perform critical illness aftercare and how it can be improved. Within a randomised controlled trial, an outreach training programme has been developed and applied.

OBJECTIVES

The aim of this study is to describe GPs' views and experiences of caring for postsepsis patients and of participating a specific outreach training.

DESIGN

Semistructured qualitative interviews.

SETTING

14 primary care practices in the metropolitan area of Berlin, Germany.

PARTICIPANTS

14 GPs who had participated in a structured sepsis aftercare programme in primary care.

RESULTS

Themes identified in sepsis aftercare were: continuity of care and good relationship with patients, GP's experiences during their patient's critical illness and impact of persisting symptoms. An outreach education as part of the intervention was considered by the GPs to be acceptable, helpful to improve knowledge of the management of postintensive care complications and useful for sepsis aftercare in daily practice.

CONCLUSIONS

GPs provide continuity of care to patients surviving sepsis. Better communication at the intensive care unit-GP interface and training in management of long-term complications of sepsis may be helpful to improve sepsis aftercare.

TRIAL REGISTRATION NUMBER

ISRCTN61744782.

摘要

背景

患有脓毒症等危重病的患者通常会长期遭受并发症的困扰。出院后,大多数患者在基层医疗机构接受治疗。对于全科医生(GP)如何进行危重病康复护理以及如何改进这一情况,目前知之甚少。在一项随机对照试验中,开发并应用了一种延伸培训计划。

目的

本研究旨在描述 GP 照顾败血症患者的观点和经验,以及他们参与特定延伸培训的情况。

设计

半结构化定性访谈。

地点

德国柏林大都市区的 14 家基层医疗诊所。

参与者

14 名曾参与基层医疗结构化脓毒症康复护理计划的 GP。

结果

脓毒症康复护理中确定的主题包括:连续性护理和与患者的良好关系、GP 在患者危重病期间的经验以及持续症状的影响。延伸教育作为干预措施的一部分被 GP 认为是可以接受的,有助于提高对重症监护后并发症管理的认识,并有助于日常实践中的脓毒症康复护理。

结论

GP 为存活的脓毒症患者提供连续性护理。在重症监护病房和 GP 之间更好的沟通,以及对脓毒症长期并发症的管理培训,可能有助于改善脓毒症康复护理。

试验注册号

ISRCTN61744782。

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