Department of Intensive Care Medicine.
Department of Nursing, Beijing Friendship Hospital.
Int J Rehabil Res. 2023 Mar 1;46(1):92-97. doi: 10.1097/MRR.0000000000000566. Epub 2023 Jan 18.
The aim of this study is to explore the factors influencing early mobilisation behaviours and patients' needs in critically ill patients after liver transplantation (LT). This interview study used phenomenological research, and Pender's health promotion model (HPM) was used to construct the interview guide. With the use of purposeful sampling, a total of 19 critically ill patients who experienced early mobilisation after LT were recruited at three tertiary hospitals in Beijing from August to November 2022. Data were collected through semi-structured interviews and analysed using Colaizzi's seven-step method. Nine themes were categorised into the three domains of Pender's HPM. The first domain was individual characteristics and experiences: (1) symptoms of end-stage liver disease limiting premobility behaviours and (2) previous treatment experience affecting understanding of early mobilisation after LT. The second domain was behaviour-specific cognition and affect: (3) coexistence of benefits and concerns in early mobilisation after LT, (4) barriers to early mobilisation after LT, (5) high self-efficacy in early mobilisation after LT, (6) individual differences in early mobilisation and (7) support and encouragement from family, wardmates and medical staff. The final domain was behavioural outcomes: (8) the need for sufficient staff, a quiet environment, safety, goals, guidance and family participation and (9) a strong willingness to comply with early mobilisation plans. The three areas and nine themes extracted in this study are helpful for the long-term development of early mobilisation in patients after LT.
本研究旨在探讨影响肝移植(LT)后重症患者早期活动行为和患者需求的因素。本访谈研究采用现象学研究方法,以彭德健康促进模式(HPM)构建访谈指南。采用目的抽样法,于 2022 年 8 月至 11 月,在北京 3 家三级医院招募了 19 例 LT 后经历早期活动的重症患者。通过半结构式访谈收集数据,并采用科莱齐的七步分析法进行分析。9 个主题被分为彭德 HPM 的 3 个领域。第一个领域是个体特征和经历:(1)终末期肝病症状限制了活动前行为;(2)既往治疗经历影响对 LT 后早期活动的理解。第二个领域是行为特异性认知和影响:(3)LT 后早期活动的益处和担忧并存;(4)LT 后早期活动的障碍;(5)LT 后早期活动的自我效能感高;(6)早期活动的个体差异;(7)来自家庭、同病房患者和医务人员的支持和鼓励。最后一个领域是行为结果:(8)需要足够的工作人员、安静的环境、安全、目标、指导和家庭参与;(9)强烈愿意遵守早期活动计划。本研究中提取的三个领域和九个主题有助于 LT 后患者早期活动的长期发展。