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医务人员对促进颈椎脊髓损伤患者加速康复因素的认知:一项定性研究。

Medical staff's perception of factors contributing to accelerated rehabilitation in patients with cervical spinal cord injury: A qualitative research.

机构信息

School of Nursing, Capital Medical University, Beijing, China.

AHPRA, Melbourne, Victoria, Australia.

出版信息

Nurs Open. 2023 Jul;10(7):4664-4675. doi: 10.1002/nop2.1715. Epub 2023 Mar 6.

DOI:10.1002/nop2.1715
PMID:36879367
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10277454/
Abstract

AIM

To explore the factors affecting the quality of accelerated rehabilitation for patients with cervical spinal cord injury, therefore, to propose targeted improvement strategies and provide reference for promoting the quality of nursing care for accelerated rehabilitation.

DESIGN

This descriptive qualitative inquiry followed the COREQ guidelines.

METHODS

From December 2020 to April 2021, 16 subjects including orthopaedic nurses, nursing management experts, orthopaedic surgeons, anaesthesiologists and physical therapists experienced in accelerated rehabilitation were selected by objective sampling method to conduct semi-structured interviews. Thematic analysis was used to analyse the interview content.

RESULTS

Through analysis and summary of the interview data, the following two themes and nine sub-themes were finally extracted. Factors related to the quality of accelerated rehabilitation structure include: construction of multidisciplinary teams, thorough system guarantee and adequate staffing. Factors related to the quality of accelerated rehabilitation process include: inadequate training and assessment, lack of medical staff's awareness, incapability of the accelerated rehabilitation team members, poor multidisciplinary communication and collaboration, lack of patient's awareness, and ineffective health education.

CONCLUSION

Quality of implementation of accelerated rehabilitation can be improved by maximizing the role of multidisciplinary team, establishing a flawless accelerated rehabilitation system, increasing allocation of nursing resources, enhancing knowledge of medical staff, improving their awareness of accelerated rehabilitation, establishing personalized clinical pathways of accelerated rehabilitation, increasing communication and collaboration among multidisciplinary disciplines, and improving health education of patients.

摘要

目的

探讨影响颈脊髓损伤患者加速康复质量的因素,从而提出有针对性的改进策略,为促进加速康复护理质量提供参考。

设计

本研究采用描述性定性研究,遵循 COREQ 指南。

方法

2020 年 12 月至 2021 年 4 月,采用客观抽样法选取骨科护士、护理管理专家、骨科医生、麻醉师和有加速康复经验的物理治疗师等 16 名研究对象进行半结构式访谈。采用主题分析法对访谈内容进行分析。

结果

通过对访谈数据的分析和总结,最终提取出两个主题和九个子主题。与加速康复质量结构相关的因素包括:多学科团队的建设、彻底的系统保障和充足的人员配备。与加速康复过程质量相关的因素包括:培训和评估不足、医护人员意识缺乏、加速康复团队成员能力不足、多学科沟通与协作不良、患者意识不足、健康教育效果不佳。

结论

通过最大限度地发挥多学科团队的作用、建立完善的加速康复体系、增加护理资源配置、提高医护人员的知识水平、增强对加速康复的认识、建立个性化的加速康复临床路径、加强多学科之间的沟通与协作、提高患者的健康教育水平,可以提高加速康复的实施质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7059/10277454/952ed7cd8447/NOP2-10-4664-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7059/10277454/5ba459587672/NOP2-10-4664-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7059/10277454/952ed7cd8447/NOP2-10-4664-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7059/10277454/5ba459587672/NOP2-10-4664-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7059/10277454/952ed7cd8447/NOP2-10-4664-g002.jpg

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Barriers to implementation of enhanced recovery after surgery (ERAS) by a multidisciplinary team in China: a multicentre qualitative study.中国多学科团队实施术后加速康复(ERAS)的障碍:一项多中心定性研究。
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