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儿童之声:从儿童视角看急诊手术的围手术期体验:一项定性研究

Kids Voices, the perioperative experience of emergency surgery from children's perspectives: A qualitative study.

作者信息

Heath Chloe, Bavich Paige, Sommerfield Aine, von Ungern-Sternberg Britta S

机构信息

Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, WA, Australia; Perioperative Medicine Team, Telethon Kids Institute, Perth, WA, Australia.

Department of Anaesthesia and Pain Medicine, Perth Children's Hospital, Perth, WA, Australia.

出版信息

Patient Educ Couns. 2023 May;110:107674. doi: 10.1016/j.pec.2023.107674. Epub 2023 Feb 13.

Abstract

OBJECTIVE

The study aimed to better understand children's emergency perioperative experience, a little researched topic. Current literature shows discrepancies between child and adult perceptions for the same healthcare experience. Acquisition of knowledge from the child's perspective can be utilized to improve perioperative care.

METHOD

This qualitative study included children (4-15 years) undergoing emergency surgery requiring general anesthesia for manipulation under anesthesia (MUA) and appendicectomy. Recruitment was opportunistic with the aim to recruit a minimum of 50 per surgical subgroup, with 109 children interviewed via telephone postoperatively. Data analysis was performed using qualitative content analysis. Participants varied in terms of age, gender, diagnosis and previous perioperative experience.

RESULTS

Qualitative content analysis found three overarching themes in association with the perioperative process: (1) fearful/apprehensive, (2) perception of powerlessness and (3) perception of trust and security. Two overarching themes were found from data relevant to the perioperative environment: (1) poor adaptation of the care environment to the children's needs and (2) positive adaptation of the care environment to the children's needs.

CONCLUSION AND PRACTICE IMPLICATIONS

The themes identified provide valuable insight into children's perioperative experience. Findings are of value to stakeholders in healthcare and are expected to inform strategies to optimize the quality of healthcare.

摘要

目的

本研究旨在更好地了解儿童围手术期急诊体验,这是一个研究较少的课题。当前文献表明,儿童和成人对相同医疗体验的认知存在差异。从儿童视角获取的知识可用于改善围手术期护理。

方法

这项定性研究纳入了接受急诊手术的儿童(4至15岁),这些手术包括在麻醉下进行手法操作(MUA)和阑尾切除术时需要全身麻醉。采用机会抽样法招募,目标是每个手术亚组至少招募50名儿童,术后通过电话对109名儿童进行了访谈。使用定性内容分析法进行数据分析。参与者在年龄、性别、诊断和既往围手术期经历方面各不相同。

结果

定性内容分析发现与围手术期过程相关的三个总体主题:(1)恐惧/担忧,(2)无助感,(3)信任与安全感。从与围手术期环境相关的数据中发现了两个总体主题:(1)护理环境对儿童需求的适应性差,(2)护理环境对儿童需求的积极适应性。

结论及实践意义

所确定的主题为儿童围手术期体验提供了有价值的见解。研究结果对医疗保健领域的利益相关者具有价值,有望为优化医疗质量的策略提供参考。

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