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患有慢性肾病的生活改变过程:一项定性研究。

A life-changing process when living with chronic kidney disease: A qualitative study.

机构信息

Department of Nephrology, Odense University Hospital, Odense, Denmark.

Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

出版信息

J Ren Care. 2024 Sep;50(3):232-240. doi: 10.1111/jorc.12481. Epub 2023 Oct 4.

Abstract

BACKGROUND

Patients with chronic kidney disease and their family members experience a number of lifestyle changes caused by the illness. The value of advance care planning includes understanding health status and options for future care, communication between close family members, and identification of wishes and preferences for care and treatment in relation to family and everyday life.

OBJECTIVE

Explore how patients with chronic kidney disease and their families experience everyday life and how they experience having to make choices about treatment.

DESIGN

An explorative study using a qualitative method with a phenomenological-hermeneutic approach.

PARTICIPANTS

Twelve patients with chronic kidney disease without kidney replacement therapy who were considering their treatment options and eight family members.

APPROACH

Individual semistructured interviews with a narrative approach were conducted between August 2021 and March 2022. The data were analysed using Ricoeur's interpretation theory on three levels: naïve reading, structural analysis and critical interpretation and discussion.

FINDINGS

One main theme was generated: Family dynamics in a life-changing process. From this, three subthemes were derived: Living in an ordinary life placed in a waiting position, The dilemma of readiness to share and Feelings of being left alone.

CONCLUSION

There are changes in family roles and in identity and a desire to maintain the known and ordinary life. Living with chronic kidney disease as a part of daily life is managed differently in the family, which can lead to feelings such as sadness, frustration and loss of shared life and resilience.

摘要

背景

慢性肾脏病患者及其家属会因疾病经历许多生活方式的改变。预先医疗照护计划的价值包括了解健康状况和未来护理方案,密切家属之间的沟通,以及确定与家庭和日常生活相关的护理和治疗意愿及偏好。

目的

探讨慢性肾脏病患者及其家属如何体验日常生活,以及他们如何体验必须做出治疗选择。

设计

采用现象学-诠释学方法的探索性研究,使用定性方法。

参与者

12 名未接受肾脏替代治疗、正在考虑治疗方案的慢性肾脏病患者和 8 名家属。

方法

2021 年 8 月至 2022 年 3 月进行个体半结构式访谈,采用叙事方法。数据使用 Ricoeur 的解释理论在三个层次上进行分析:朴素阅读、结构分析和批判性解释与讨论。

结果

生成了一个主要主题:改变生活过程中的家庭动态。从中得出三个次主题:生活在等待位置的平凡生活、准备分享的困境和感觉被孤立。

结论

家庭角色和身份发生变化,渴望维持已知的平凡生活。将慢性肾脏病作为日常生活的一部分来管理,在家庭中会有所不同,这可能导致悲伤、沮丧和失去共同生活以及韧性等感觉。

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