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心脏康复患者睡眠障碍筛查、管理及转诊的障碍与促进因素:一项质性描述性研究

Barriers and enablers to screening, management and referral of sleep disorders in patients attending cardiac rehabilitation: A qualitative descriptive study.

作者信息

Le Grande Michael R, Murphy Barbara, Kerr Debra, Beauchamp Alison, Driscoll Andrea, Jackson Alun C

机构信息

Australian Centre for Heart Health, North Melbourne, Victoria, Australia.

Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.

出版信息

J Adv Nurs. 2024 Jan;80(1):136-149. doi: 10.1111/jan.15765. Epub 2023 Jul 4.

Abstract

AIMS

To examine healthcare professional's knowledge about assessment and management of sleep disorders for cardiac patients and to describe the barriers to screening and management in cardiac rehabilitation settings.

DESIGN

A qualitative descriptive study. Data were collected via semi-structured interviews.

METHODS

In March 2022, a total of seven focus groups and two interviews were conducted with healthcare professionals who currently work in cardiac rehabilitation settings. Participants included 17 healthcare professionals who had undertaken cardiac rehabilitation training within the past 5 years. The study adheres to the consolidated criteria for reporting qualitative research guidelines. An inductive thematic analysis approach was utilized.

RESULTS

Six themes and 20 sub-themes were identified. Non-validated approaches to identify sleep disorders (such as asking questions) were often used in preference to validated instruments. However, participants reported positive attitudes regarding screening tools provided they did not adversely affect the therapeutic relationship with patients and benefit to patients could be demonstrated. Participants indicated minimal training in sleep issues, and limited knowledge of professional guidelines and recommended that more patient educational materials are needed.

CONCLUSION

Introduction of screening for sleep disorders in cardiac rehabilitation settings requires consideration of resources, the therapeutic relationship with patients and the demonstrated clinical benefit of extra screening. Awareness and familiarity of professional guidelines may improve confidence for nurses in the management of sleep disorders for patients with cardiac illness.

IMPACTS

The findings from this study address healthcare professionals' concerns regarding introduction of screening for sleep disorders for patients with cardiovascular disease. The results indicate concern for therapeutic relationships and patient management and have implications for nursing in settings such as cardiac rehabilitation and post-cardiac event counselling.

REPORTING METHOD

Adherence to COREQ guidelines was maintained.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution as this study explored health professionals' experiences only.

摘要

目的

探讨医疗保健专业人员对心脏病患者睡眠障碍评估与管理的知识,并描述心脏康复环境中筛查和管理的障碍。

设计

一项定性描述性研究。通过半结构化访谈收集数据。

方法

2022年3月,对目前在心脏康复环境中工作的医疗保健专业人员进行了总共7次焦点小组讨论和2次访谈。参与者包括17名在过去5年内接受过心脏康复培训的医疗保健专业人员。该研究遵循定性研究报告的综合标准。采用归纳主题分析方法。

结果

确定了6个主题和20个子主题。识别睡眠障碍的未经验证的方法(如提问)通常比经过验证的工具更受青睐。然而,参与者表示,只要筛查工具不会对与患者的治疗关系产生不利影响,并且能够证明对患者有益,他们对筛查工具持积极态度。参与者表示在睡眠问题方面的培训很少,对专业指南的了解有限,并建议需要更多的患者教育材料。

结论

在心脏康复环境中引入睡眠障碍筛查需要考虑资源、与患者的治疗关系以及额外筛查所显示的临床益处。对专业指南的认识和熟悉程度可能会提高护士对心脏病患者睡眠障碍管理的信心。

影响

本研究的结果解决了医疗保健专业人员对为心血管疾病患者引入睡眠障碍筛查的担忧。结果表明对治疗关系和患者管理的关注,并对心脏康复和心脏事件后咨询等环境中的护理有影响。

报告方法

保持对COREQ指南的遵循。

患者或公众贡献

由于本研究仅探讨了卫生专业人员的经验,因此没有患者或公众贡献。

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