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基于家庭的肾衰竭干预设计:三方“血液透析患者/家庭照顾者/医疗保健专业人员”的观点。

Designing family-based interventions in kidney failure: The perspectives of the triad 'patients on haemodialysis/family caregivers/healthcare professionals.

机构信息

Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.

Department of Psychology, East Carolina University, Greenville, North Carolina, USA.

出版信息

Br J Health Psychol. 2023 Sep;28(3):672-689. doi: 10.1111/bjhp.12647. Epub 2023 Jan 31.

Abstract

OBJECTIVES

This study explored the perspectives of people undergoing in-centre haemodialysis, family caregivers, and healthcare professionals about the development and implementation of family-based interventions in renal care settings.

DESIGN

A qualitative exploratory study was carried out combining purposive and snowball sampling techniques.

METHODS

Semi-structured interviews were submitted to thematic analysis.

RESULTS

A total of 82 individuals (27 adults on haemodialysis, 32 family caregivers, and 23 healthcare professionals) participated in this study. Five major themes were identified: (i) educational needs (improve disease and treatment-related knowledge; acquire better clarification on dialysis-related health behaviours); (ii) support needs (easier access to available community resources and professional psychological support; additional emotional and instrumental support from family members); (iii) expected barriers (concerns about participating in a group format; availability of the person on haemodialysis/family caregiver dyad; travel to the intervention site and associated costs); (iv) expected benefits (mutual emotional validation and support; improve family coping skills and involvement); and (v) preferences for content and format (interdisciplinary and moderated by health psychologists) and timing of the intervention (weekends and/or non-dialysis days).

CONCLUSIONS

Findings suggested that interventions focused on the family system in kidney failure need to follow an interdisciplinary approach, combining psychosocial support with an educational component. Future research is needed to minimize barriers to the conjoint participation of the person on haemodialysis/caregiver dyad. This study identifies important intervention goals to inform the design of family-based interventions for people receiving haemodialysis and their family caregivers.

摘要

目的

本研究探讨了接受中心血液透析的患者、家庭照顾者和医疗保健专业人员对在肾脏护理环境中制定和实施以家庭为基础的干预措施的看法。

设计

采用目的抽样和滚雪球抽样技术进行定性探索性研究。

方法

对半结构式访谈进行主题分析。

结果

共有 82 人(27 名血液透析成人、32 名家庭照顾者和 23 名医疗保健专业人员)参与了这项研究。确定了五个主要主题:(i)教育需求(提高疾病和治疗相关知识;更好地了解透析相关的健康行为);(ii)支持需求(更容易获得可用的社区资源和专业心理支持;家庭成员提供更多的情感和实际支持);(iii)预期障碍(对参与小组形式的担忧;血液透析患者/家庭照顾者对的可用性;前往干预地点和相关费用);(iv)预期获益(相互情感认可和支持;改善家庭应对技能和参与度);(v)内容和格式偏好(跨学科且由健康心理学家主持)和干预时间(周末和/或非透析日)。

结论

研究结果表明,针对肾衰竭患者家庭系统的干预措施需要采用跨学科方法,将心理社会支持与教育内容相结合。需要进一步研究以减少血液透析患者/照顾者对共同参与的障碍。本研究确定了重要的干预目标,为设计针对接受血液透析的患者及其家庭照顾者的以家庭为基础的干预措施提供了信息。

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