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照顾尿路造口患者的照护者体验:一项定性研究。

Caregiver experiences of caring for family members with urostomy: a qualitative study.

机构信息

Shanxi Medical University, Shanxi, China.

First Hospital of Shanxi Medical University, Shanxi, China.

出版信息

Support Care Cancer. 2024 Feb 19;32(3):167. doi: 10.1007/s00520-024-08376-8.

Abstract

OBJECTIVE

In China, bladder tumors rank first for morbidity and mortality among urological and reproductive system tumors. Total radical cystectomy plus urinary flow conversion is the gold standard for the treatment of muscle-layer invasive bladder cancer. With an increasing number of radical cystectomies each year, the number of patients living with urostomy is growing. After discharge, primary care of urostomy patients is given at home, and high demands are placed on home caregivers due to issues of privacy and the complexity of replacing the urostomy device. This research explored the challenges faced by the family caregivers of urostomy patients.

METHODS

We used descriptive qualitative research methods to conduct interviews with twenty-five family caregivers of patients with urostomy. Survey subjects were from five general hospitals. All interviews were recorded, transcribed, and analyzed using thematic analysis.

RESULTS

Three critical challenges were identified-confusion, family crisis, and struggle psychology. Within these three themes, six sub-themes were constructed by coders. They were knowledge and skill deficiency, strong insecurities and uncertainties, role conflict, economic burden, emotional overwhelmed and calm acceptance.

CONCLUSION

Family caregivers play a critical role in patient care, and especially in urostomy care. Caregiving is associated with significant challenges that hinder the family caregiver's ability to effectively care for the patient, further diminishing the caregiver's quality of life. Therefore, healthcare professionals should consider the challenges faced by family caregivers and take measures to obviate them through education, preparation, and support.

摘要

目的

在中国,膀胱癌在泌尿系统和生殖系统肿瘤的发病率和死亡率中均位居第一。全膀胱切除术加尿路改流术是肌层浸润性膀胱癌的金标准治疗方法。随着每年全膀胱切除术数量的增加,带造口的患者人数也在增加。患者出院后,主要在家中进行造口护理,由于隐私问题和造口更换装置的复杂性,对家庭护理人员的要求很高。本研究探讨了造口患者家庭护理人员所面临的挑战。

方法

我们使用描述性定性研究方法,对 25 名造口患者的家庭护理人员进行了访谈。调查对象来自五家综合医院。所有访谈均进行了录音、转录,并使用主题分析进行了分析。

结果

确定了三个关键挑战——困惑、家庭危机和挣扎心理。在这三个主题中,由编码员构建了六个子主题:知识和技能不足、强烈的不安全感和不确定性、角色冲突、经济负担、情绪失控和冷静接受。

结论

家庭护理人员在患者护理中起着至关重要的作用,尤其是在造口护理方面。护理工作存在重大挑战,这阻碍了家庭护理人员有效照顾患者的能力,进一步降低了护理人员的生活质量。因此,医疗保健专业人员应考虑家庭护理人员面临的挑战,并通过教育、准备和支持来采取措施消除这些挑战。

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