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患者视角——骨折相关感染经历的定性分析

The patients' perspective - a qualitative analysis of experiencing a fracture-related infection.

作者信息

Wimalan Bravena, Rupp Markus, Alt Volker, Walter Nike

机构信息

Department for Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany.

Department for Psychosomatic Medicine, University Medical Center Regensburg, Regensburg, Germany.

出版信息

Front Psychol. 2023 Jun 1;14:1126826. doi: 10.3389/fpsyg.2023.1126826. eCollection 2023.

Abstract

INTRODUCTION

Fracture-related infection is a devastating complication confronting the patient with several challenges. To improve the management and to enhance the patients' wellbeing the focus of this study was to understand the emotional impact and patients' experiences during the process to identify challenges, difficulties, and resources. For this, a qualitative content analysis of semi-structured interviews according to Graneheim and Lundman was performed.

METHODS

In total  = 20 patients of a German university orthopedic trauma centre specialized in bone and joint infections were recruited using a purposive sampling strategy. The patients were treated at the hospital between 2019 and 2021 and underwent at least one surgery. Individual in-person interviews were performed by one researcher based on a semi-structured guide, which was previously conceptualized. Content analysis according to Graneheim and Lundman was performed on the transcripts by two of the researchers independently.

RESULTS

The following major themes emerged: (i) the emotional and mental aspects highlighting the fact that FRI patients faced severe restrictions in their day-to-day life, which resulted in dependency on others and frustration, as well as future concerns showing that patients could not overcome a state of anxiety and fear even after successful treatment, (ii) socioeconomic consequences confronting patients with consequences on the job and in finances where they often feel helpless, and (iii) resources emphasizing the role of spirituality as a coping strategy and yoga exercises for keeping the positivity.

CONCLUSION

This study emphasized the challenge of fracture-related infection management and associated consequences from the patients' perspective. Not being well informed about possible negative outcomes or restrictions makes it harder for patients to accept the situation and patients expressed a need for better information and certainty. Also, patients developed constant anxiety and other psychological disturbances, highlighting the potential benefit of psychological support and patient-peer support to exchange experiences.

摘要

引言

骨折相关感染是一种严重的并发症,给患者带来诸多挑战。为了改善治疗管理并提升患者的健康状况,本研究的重点是了解患者在整个过程中的情绪影响和经历,以识别挑战、困难及资源。为此,我们依据格兰内海姆和伦德曼的方法对半结构化访谈进行了定性内容分析。

方法

采用目的抽样策略,从德国一所专门治疗骨与关节感染的大学骨科创伤中心招募了总共20名患者。这些患者于2019年至2021年期间在该医院接受治疗,且至少接受了一次手术。由一名研究人员根据预先构思的半结构化指南进行个人面对面访谈。两名研究人员独立对访谈记录进行了依据格兰内海姆和伦德曼方法的内容分析。

结果

出现了以下几个主要主题:(i)情绪和心理方面,突出了骨折相关感染患者在日常生活中面临严重限制,这导致他们依赖他人并感到沮丧,以及对未来的担忧,表明即使在成功治疗后患者仍无法克服焦虑和恐惧状态;(ii)社会经济后果,患者在工作和财务方面受到影响,他们常常感到无助;(iii)资源方面,强调了精神性作为一种应对策略的作用以及瑜伽练习对保持积极心态的作用。

结论

本研究从患者角度强调了骨折相关感染治疗管理的挑战及相关后果。患者对可能的负面结果或限制了解不足,使得他们更难接受现状,患者表示需要更好的信息和确定性。此外,患者出现持续焦虑和其他心理困扰,凸显了心理支持和患者同伴支持以交流经验的潜在益处。

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