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冠心病合并衰弱患者出院后营养管理:定性研究。

Post-discharge nutritional management for patients with coronary heart disease and frailty: a qualitative study.

机构信息

The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.

School of Nursing, Zunyi Medical University, Zunyi, Guizhou, China.

出版信息

BMC Geriatr. 2024 Mar 19;24(1):268. doi: 10.1186/s12877-024-04885-7.

Abstract

BACKGROUND

Frail elderly patients experience physiological function and reserve depletion, leading to imbalances in their internal environment, which increases the risk of coronary heart disease recurrence and malnutrition. However, the majority of these patients, who primarily have a low level of education and lack self-management skills, face difficulties actively dealing with obstacles during the transition period after their discharge from hospitalization. Therefore, it is necessary to understand and discuss in depth the nutrition management experience of discharged elderly patients with coronary heart disease and frailty (ages 65-80 years old) and to analyze the promoting and hindering factors that affect scientific diet behavior during the discharge transition period.

METHODS

Fifteen elderly patients with coronary heart disease and frailty who had been discharged from the hospital for 6 months were interviewed using a semistructured method. The directed content analysis approach to descriptive research was used to extract topics from the interview content.

RESULTS

All participants discussed the problems in health nutrition management experience of discharged. Five topics and ten subtopics were extracted, such as ①Weak perceptions and behaviors towards healthy eating (personal habit solidification, negative attitudes towards nutrition management), ②Lack of objective factors for independently adjusting dietary conditions (reliance on subjective feelings, times of appetite change), ③Personal hindrance factors (memory impairment, deficiencies in self-nutrition management), ④Expected external support (assistance care support, ways to obtain nutritional information), ⑤Lack of continuous nutrition management (interruption of professional guidance, avoidance of medical treatment behavior).

CONCLUSIONS

Nutrition management after discharge places a burden on elderly patients with coronary heart disease and frailty. According to the patients' physical conditions, we should develop a diet support system that is coordinated by individuals, families and society.

摘要

背景

虚弱的老年患者经历生理功能和储备耗竭,导致内部环境失衡,增加了冠心病复发和营养不良的风险。然而,这些患者大多数文化程度较低,缺乏自我管理技能,在住院出院后的过渡期积极应对障碍存在困难。因此,有必要深入了解和讨论出院老年冠心病和衰弱患者(年龄 65-80 岁)的营养管理经验,并分析影响出院过渡期科学饮食行为的促进和阻碍因素。

方法

采用半结构式访谈方法,对 15 名出院 6 个月的老年冠心病和衰弱患者进行访谈。采用描述性研究的定向内容分析方法,从访谈内容中提取主题。

结果

所有参与者都讨论了出院后健康营养管理经验中的问题。提取出 5 个主题和 10 个子主题,如 ①健康饮食意识和行为薄弱(个人习惯固化,对营养管理的消极态度)、②独立调整饮食条件的客观因素不足(依赖主观感受,食欲变化的时间)、③个人障碍因素(记忆力减退,自我营养管理不足)、④预期的外部支持(护理支持,获取营养信息的途径)、⑤缺乏持续的营养管理(专业指导中断,避免治疗行为)。

结论

出院后的营养管理给冠心病和衰弱的老年患者带来了负担。根据患者的身体状况,我们应该开发一个由个人、家庭和社会协调的饮食支持系统。

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本文引用的文献

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Frailty in older adults with heart disease.老年心脏病患者的虚弱问题。
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