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存活只是康复的开始:一项对严重创伤后幸存者经历的定性研究。

Survival Is Just the Beginning of Recovery: A Qualitative Study of Survivors' Experiences after Severe Injury.

机构信息

Department of Medical Humanities and Education, School of Medicine, Kyungpook National University, Daegu, Korea.

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Yonsei Med J. 2024 Dec;65(12):703-717. doi: 10.3349/ymj.2023.0459.

Abstract

PURPOSE

Patients experience severe physical trauma every year. However, studies on survivors' experiences after severe injury are limited. Previous studies have mainly focused on time spans of trauma treatment. This study aimed to comprehensively explore survivors' experiences to improve the current quality of trauma treatment and highlight the importance of patient-centered care.

MATERIALS AND METHODS

Structured, face-to-face interviews with six domains were conducted on survivors aged ≥18 years who were previously hospitalized in an intensive care unit due to traumatic injuries. Self-reported questionnaires were administered for a multidimensional assessment of participants' conditions. Transcripts of each narrative were analyzed per grounded theory.

RESULTS

Fourteen participants were assessed. The median injury severity score was 25.5. The median elapsed time from injury to interview was 17.3 months. The physical and psychiatric difficulties of the participants remained unresolved even after completing rehabilitation. The main theme derived from the narratives were struggle with injury, consequences, and contributing factors, with the following subthemes: 1) suffering from injury and treatment, 2) psychological adaptation to the changed self and life after the accident, 3) significant family support, 4) gratitude to medical staff despite inadequacies in the healthcare system, and 5) legal and economic issues that impede recovery.

CONCLUSION

Increased efforts focusing on enabling survivors of severe injury to return to society and improve their quality of life are needed, including the establishment of patient-centered care in the trauma field, extended care for the survivors' families, multidisciplinary treatment, and the collection of quantitative post-discharge data.

摘要

目的

患者每年都会经历严重的身体创伤。然而,关于严重损伤幸存者体验的研究有限。既往研究主要集中在创伤治疗的时间段上。本研究旨在全面探讨幸存者的体验,以提高当前创伤治疗的质量,并强调以患者为中心的护理的重要性。

材料与方法

对 18 岁及以上因创伤而在重症监护病房住院的幸存者进行了 6 个领域的结构化、面对面访谈。对参与者的状况进行了多维评估,并进行了自我报告问卷。对每个叙述的文字记录都进行了扎根理论分析。

结果

评估了 14 名参与者。损伤严重程度评分中位数为 25.5。从损伤到访谈的中位数时间为 17.3 个月。即使完成了康复,参与者的身体和精神困难仍未得到解决。从叙述中得出的主要主题是受伤、后果和促成因素的斗争,包括以下子主题:1)受伤和治疗的痛苦,2)对事故后自身和生活变化的心理适应,3)重大的家庭支持,4)对医护人员的感激之情,尽管医疗体系存在不足,5)法律和经济问题阻碍了康复。

结论

需要更加努力地帮助严重损伤幸存者重返社会并提高生活质量,包括在创伤领域建立以患者为中心的护理、为幸存者的家庭提供延伸护理、多学科治疗以及收集定量出院后数据。

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Patient experiences of initial trauma care.患者的初始创伤护理体验。
Int Emerg Nurs. 2019 Jan;42:25-29. doi: 10.1016/j.ienj.2018.08.003. Epub 2018 Sep 28.

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