运用主题分析法探索精神分裂症和茧居患者的精神科家访护理实践。

Exploring Psychiatric Home-Visit Nursing Practices for Patients with Schizophrenia and Hikikomori with a Thematic Analysis.

机构信息

Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe 6540142, Japan.

Faculty of Nursing, Osaka Shin-Ai Gakuin University, 6-2-28 Tsurumi, Tsurumi-ku, Osaka 5380053, Japan.

出版信息

Int J Environ Res Public Health. 2024 Feb 5;21(2):181. doi: 10.3390/ijerph21020181.

Abstract

The phenomenon of some patients with schizophrenia withdrawing and becoming hikikomori needs to be resolved. In some countries, outreach methods are being employed. In Japan, psychiatric home-visit nursing for patients with schizophrenia and hikikomori is being implemented. However, it is not based on sufficient evidence and relies on the experience and intuition of individual nurses. This study explored the underlying themes in the nursing practices of psychiatric home-visit nurses via semi-structured interviews with 10 nurses and a thematic analysis. Nine key themes emerged. Four themes-(i) understanding the patient's world, (ii) supporting the patients as they are, (iii) providing a sense of relief, and (iv) having equal relationships-highlighted the nurses' commitment to respecting patients' individuality while building and sustaining relationships. Two themes-(v) exploring the right timing and (vi) waiting for the appropriate timing-illustrated the nurses' anticipation of proactive patient engagement. Finally, three themes-(vii) working together on things, (viii) continuing care for expanding the patient's world, and (ix) nursing care for the patient's future-underscored the nurses' gradual and methodical approach to working alongside patients. Nursing practices based on these nine themes cultivated meaningful relationships and secured a sense of relief for the patients. Additionally, they awaited patients' proactive engagement and delivered timely support to facilitate positive daily life changes. These findings contribute to the establishment of evidence-based nursing practices for patients with schizophrenia and hikikomori.

摘要

一些精神分裂症患者出现退缩并成为蛰居族的现象需要得到解决。一些国家正在采用外展方法。在日本,正在为精神分裂症和蛰居族患者实施精神科家访护理。然而,这种方法并不是基于充分的证据,而是依赖于个别护士的经验和直觉。本研究通过对 10 名护士进行半结构化访谈和主题分析,探讨了精神科家访护士护理实践中的潜在主题。出现了 9 个关键主题。四个主题——(一)理解患者的世界,(二)支持患者的现状,(三)提供解脱感,以及(四)建立平等关系——强调了护士尊重患者个性的承诺,同时建立和维持关系。两个主题——(五)探索正确的时机和(六)等待适当的时机——说明了护士对积极主动的患者参与的预期。最后,三个主题——(七)共同处理事情,(八)继续护理以扩大患者的世界,以及(九)为患者的未来提供护理——强调了护士与患者一起逐步和有条不紊地工作的方法。基于这九个主题的护理实践培养了有意义的关系,为患者带来了解脱感。此外,它们还等待着患者的积极参与,并及时提供支持,以促进积极的日常生活变化。这些发现为精神分裂症和蛰居族患者建立基于证据的护理实践做出了贡献。

相似文献

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索