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迈向安全之家:体验向家庭机械通气门诊环境的过渡。一项主题分析

[Toward a safe home: Experiencing the transition to an outpatient setting with home mechanical ventilation. A thematic analysis].

作者信息

Brüll Nicole, Nicca Dunja, Staudacher Sandra, Schmid-Mohler Gabriela, Zúñiga Franziska

机构信息

Departement Muskuloskelettales System, Universitätsspital Basel, Schweiz.

Institut für Epidemiologie, Biostatistik und Prävention, Universität Zürich, Schweiz.

出版信息

Pflege. 2023;36(5):269-276. doi: 10.1024/1012-5302/a000943. Epub 2023 Jun 19.

Abstract

Toward a safe home: Experiencing the transition to an outpatient setting with home mechanical ventilation. A thematic analysis With the progress in medical options, the need for home mechanical ventilation increases. The transition from long-term ventilation in an institution to home mechanical ventilation in an outpatient setting is a difficult phase in terms of setting up the network of care, coordination of care for those with the ventilatory insufficiency and the financing. The study describes how patients with ventilatory insufficiency and family caregivers experience the transition from an institution to an ambulatory setting with invasive or non-invasive home mechanical ventilation. A qualitative research design with a social-constructivist approach was adopted using thematic analysis according to Braun and Clarke. We included seven German-speaking patients (≥ 18 years old) with ventilatory insufficiency and home mechanical ventilation (> 6 h/day) from the German part of Switzerland, with discharge from an institution to home, and five family caregivers who care for patients with the described criteria. The institution was seen as a safe place. Affected persons and their family caregivers had to create a safe environment at home. Three themes were formed inductively: To gradually build trust with each other, to become experts as family caregivers, to align their own network with the new care needs. The transition home succeeds in the interplay of gaining trust, building expertise, and creating sustainable networks. Professionals can use this knowledge to provide targeted support to patients with home mechanical ventilation and their family caregivers.

摘要

迈向安全之家

体验向家庭机械通气门诊环境的过渡。一项主题分析 随着医疗选择的进步,家庭机械通气的需求增加。从机构内的长期通气过渡到门诊环境中的家庭机械通气,在建立护理网络、协调通气功能不全患者的护理以及资金筹集方面是一个困难阶段。该研究描述了通气功能不全患者及其家庭照顾者如何体验从机构到侵入性或非侵入性家庭机械通气门诊环境的过渡。采用了基于社会建构主义方法的定性研究设计,并根据布劳恩和克拉克的方法进行主题分析。我们纳入了来自瑞士德语区的7名通气功能不全且使用家庭机械通气(每天>6小时)、从机构出院回家的德语患者(≥18岁),以及5名照顾符合上述标准患者的家庭照顾者。机构被视为一个安全的地方。患者及其家庭照顾者必须在家中营造一个安全的环境。归纳形成了三个主题:相互逐渐建立信任、成为家庭照顾方面的专家、使自己的社交网络与新的护理需求相匹配。回家的过渡在获得信任、积累专业知识和创建可持续网络的相互作用中取得成功。专业人员可以利用这些知识为家庭机械通气患者及其家庭照顾者提供有针对性的支持。

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