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支持髋部骨折手术后患者的非正式照护者的观点:一项嵌入 HIP HELPER 可行性试验的定性研究。

Perspectives of informal caregivers who support people following hip fracture surgery: a qualitative study embedded within the HIP HELPER feasibility trial.

机构信息

School of Health Sciences, University of East Anglia, Norwich, UK

School of Health Sciences, University of East Anglia, Norwich, UK.

出版信息

BMJ Open. 2023 Nov 17;13(11):e074095. doi: 10.1136/bmjopen-2023-074095.

Abstract

OBJECTIVES

This study aims to illuminate the perspectives of informal caregivers who support people following hip fracture surgery.

DESIGN

A qualitative study embedded within a now completed multicentre, feasibility randomised controlled trial (HIP HELPER).

SETTING

Five English National Health Service hospitals.

PARTICIPANTS

We interviewed 20 participants (10 informal caregivers and 10 people with hip fracture), following hip fracture surgery. This included one male and nine females who experienced a hip fracture; and seven male and three female informal caregivers. The median age was 72.5 years (range: 65-96 years), 71.0 years (range: 43-81 years) for people with hip fracture and informal caregivers, respectively.

METHODS

Semistructured, virtual interviews were undertaken between November 2021 and March 2022, with caregiver dyads (person with hip fracture and their informal caregiver). Data were analysed thematically.

FINDINGS

We identified two main themes: expectations of the informal caregiver role and reality of being an informal caregiver; and subthemes: expectations of care and services; responsibility and advocacy; profile of people with hip fracture; decision to be a caregiver; transition from hospital to home.

CONCLUSION

Findings suggest informal caregivers do not feel empowered to advocate for a person's recovery or navigate the care system, leading to increased and unnecessary stress, anxiety and frustration when supporting the person with hip fracture. We suggest that a tailored information giving on the recovery pathway, which is responsive to the caregiving population (ie, considering the needs of male, younger and more active informal caregivers and people with hip fracture) would smooth the transition from hospital to home.

TRIAL REGISTRATION NUMBER

ISRCTN13270387.Cite Now.

摘要

目的

本研究旨在阐明支持髋部骨折手术后患者的非专业照护者的观点。

设计

一项嵌入在已完成的多中心、可行性随机对照试验(HIP HELPER)中的定性研究。

地点

5 家英国国家医疗服务体系医院。

参与者

我们对 20 名参与者(10 名非专业照护者和 10 名髋部骨折患者)进行了采访,这些参与者在髋部骨折手术后接受了采访。这包括一名男性和 9 名女性髋部骨折患者;以及 7 名男性和 3 名女性非专业照护者。中位数年龄为 72.5 岁(范围:65-96 岁),髋部骨折患者和非专业照护者的年龄分别为 71.0 岁(范围:43-81 岁)。

方法

2021 年 11 月至 2022 年 3 月期间,对护理者二人组(髋部骨折患者及其非专业照护者)进行了半结构化虚拟访谈。对数据进行了主题分析。

发现

我们确定了两个主要主题:非专业照护者角色的期望和现实;以及子主题:对护理和服务的期望;责任和倡导;髋部骨折患者的特征;成为照护者的决定;从医院到家庭的过渡。

结论

研究结果表明,非专业照护者在为患者的康复或为患者导航护理系统方面没有感到有能力,这导致在支持髋部骨折患者时增加了不必要的压力、焦虑和沮丧。我们建议,根据护理人群(即考虑男性、年轻和更活跃的非专业照护者以及髋部骨折患者的需求),提供针对康复途径的量身定制信息,这将有助于顺利从医院过渡到家庭。

试验注册编号

ISRCTN80421554.Cite Now.

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