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理解从住院康复到家庭护理的主要下肢截肢患者的过渡:一项描述性定性研究。

Understanding transitions in care for people with major lower limb amputations from inpatient rehabilitation to home: a descriptive qualitative study.

机构信息

Department of Physical Therapy, University of Toronto, Toronto, Canada.

Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.

出版信息

Disabil Rehabil. 2022 Aug;44(16):4211-4219. doi: 10.1080/09638288.2021.1882009. Epub 2021 Feb 18.

Abstract

PURPOSE

To understand how people with major limb amputation experience the transition in care from inpatient rehabilitation to the community.

METHOD

A qualitative study was conducted using semi-structured interviews. Individuals were eligible if they had undergone a major lower limb amputation and had been discharged from inpatient rehabilitation to the community within one to twelve months. Interviews explored participants' experiences and factors associated with the transition in care. The interviews were audio-recorded, transcribed, and thematically analyzed.

RESULTS

Nine individuals with major lower limb amputation participated. Five themes were identified to describe the transition in care experience: (a) Preparedness: differing experiences during inpatient rehabilitation; (b) Challenges with everyday tasks: "everything has to be thought out"; (c) Importance of coping strategies; "gradually you accept it more and more" (d) Importance of support and feeling connected; "if I needed anything, they're right there" and (e) Not everyone has access to the same resources: "left to your own devices".

CONCLUSIONS

The identified themes concurrently influenced the transition from inpatient rehabilitation to the community. Common challenges during the initial transition were identified. Areas of improvement within inpatient rehabilitation included individualized care, discussions surrounding expectations, and better access to ongoing community support.Implication for rehabilitationTransition in care are difficult and vulnerable times for people with major lower limb amputation, especially when transitioning home following inpatient rehabilitation.Rehabilitation should prepare individuals for completing meaningful tasks in the home and community.Access to ongoing support in the community in the form of practical and emotional support can ease the challenges of transitioning home.

摘要

目的

了解下肢大截肢患者在从住院康复到社区过渡期间的体验。

方法

采用半结构式访谈进行定性研究。参与者需满足以下条件:已接受下肢大截肢手术,且在出院后 1 至 12 个月内已从住院康复过渡到社区。访谈探讨了参与者的经历以及与护理过渡相关的因素。访谈进行了录音、转录,并进行了主题分析。

结果

9 名下肢大截肢患者参与了研究。确定了五个主题来描述护理过渡的体验:(a) 准备情况:住院康复期间的不同经历;(b) 日常任务的挑战:“一切都必须深思熟虑”;(c) 应对策略的重要性:“逐渐接受更多”;(d) 支持和联系的重要性:“如果我需要任何帮助,他们就在那里”;(e) 并非每个人都能获得相同的资源:“只能靠自己”。

结论

确定的主题同时影响了从住院康复到社区的过渡。确定了初始过渡期间的常见挑战。住院康复中可以改进的领域包括个性化护理、围绕期望进行讨论以及更好地获得持续的社区支持。

康复意义

对下肢大截肢患者来说,从住院康复到社区的过渡是困难和脆弱的时期,尤其是当他们从住院康复后返回家中时。康复应该使个人能够在家中和社区中完成有意义的任务。以实际和情感支持形式在社区中获得持续支持可以减轻过渡到家庭的挑战。

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