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儿童通气管手术后的术后护理:挪威父母随时间推移的经历的定性研究。

Postoperative care for children after ventilation tube surgery: A qualitative study of parents' experiences over time in Norway.

作者信息

Austad Bjarne, Nilsen Ann Helen, Thorstensen Wenche Moe, Helvik Anne-Sofie

机构信息

General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491 Trondheim, Norway; Øya Medical Centre, Prinsensgate 1 A, 7013 Trondheim, Norway.

Department of Otolaryngology, Head and Neck Surgery, St. Olavs University Hospital, Postbox 3250, 7006 Trondheim, Norway.

出版信息

Am J Otolaryngol. 2024 Nov-Dec;45(6):104457. doi: 10.1016/j.amjoto.2024.104457. Epub 2024 Aug 3.

DOI:10.1016/j.amjoto.2024.104457
PMID:39154491
Abstract

OBJECTIVE

To explore the parents' experience of postoperative care during the first two years after ventilation tube (VT) surgery in a setting where the check-ups were conducted either by otolaryngologists or their regular general practitioner (GP).

METHODS

55 individual interviews of parents at up to three different time points (<1, 6, and 24 months) after their child received VT-surgery, analyzed with reflexive thematic analysis.

RESULTS

  1. Parents' trust in the healthcare system and responsibility for booking check-ups. Nearly all parents seemed to maintain trust in the healthcare system and felt safeguarded regardless of where they had their check-ups. Still, they would prefer otolaryngologist-led care if they could choose from the top shelf. They took responsibility for seeking healthcare when needed and experienced that their GP referred their child if necessary. 2. As time goes by, parental worries are reduced. Most experienced that their child stayed healthy after surgery, and their demand for postoperative check-ups decreased. For the children who faced ongoing issues, most parents experienced that their child's challenges had been handled professionally, and they became less worried. Some parents attribute other diagnoses to their child's behavior or speech delays, refining their understanding of their child's condition. 3. The desire for closure. Parents sought reassurance about their child's recovery and desired professional evaluation for closure. While some advocated for audiometry, others trusted their own assessments about hearing. The transition to school marked a pivotal time, prompting concerns about social inclusion.

CONCLUSION

Overall, the parents experienced that their child was safeguarded irrespective of whether postoperative care was provided by otolaryngologists or GPs. Still, many preferred check-ups by an otolaryngologist. The parental worries and focus on the VTs were reduced as time went by after surgery, but even so many wanted a 'closure' to be sure that the hearing was as good as it could be and the VTs rejected. We advocate for an individualized approach to postoperative care that addresses specific medical needs without imposing unnecessary check-ups.

摘要

目的

探讨在由耳鼻喉科医生或其常规全科医生进行检查的情况下,家长在置管(VT)手术后头两年的术后护理体验。

方法

对55名接受VT手术的儿童家长在术后最多三个不同时间点(<1个月、6个月和24个月)进行个体访谈,并采用反思性主题分析法进行分析。

结果

  1. 家长对医疗保健系统的信任以及预约检查的责任。几乎所有家长似乎都对医疗保健系统保持信任,并且无论在哪里进行检查都感到安心。不过,如果可以选择的话,他们更倾向于由耳鼻喉科医生主导的护理。他们负责在需要时寻求医疗保健,并体验到他们的全科医生在必要时会转诊他们的孩子。2. 随着时间推移,家长的担忧减少。大多数家长体验到他们的孩子术后保持健康,并且他们对术后检查的需求减少。对于面临持续问题的孩子,大多数家长体验到他们孩子的问题得到了专业处理,他们的担忧也减少了。一些家长将其他诊断归因于孩子的行为或言语延迟,从而完善了他们对孩子病情的理解。3. 对结束的渴望。家长寻求关于孩子康复的安心,并希望得到专业评估以确定是否结束。虽然一些人主张进行听力测定,但另一些人则信任自己对听力的评估。进入学校标志着一个关键时期,引发了对社会融入的担忧。

结论

总体而言,家长体验到无论术后护理是由耳鼻喉科医生还是全科医生提供,他们的孩子都得到了保障。不过,许多人更喜欢由耳鼻喉科医生进行检查。术后随着时间推移,家长的担忧以及对置管的关注减少了,但即便如此,许多人仍希望得到“确认”,以确保听力尽可能良好且置管已排出。我们提倡采用个性化的术后护理方法,满足特定的医疗需求,同时避免进行不必要的检查。

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