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理解衰弱:一项关于老年心力衰竭患者衰弱体验及对医护人员衰弱认知的定性研究

Understanding frailty: a qualitative study of older heart failure patients' frail experience and perceptions of healthcare professionals with frailty.

作者信息

Liu Si, Xiong Xiao-Yun, Guo Ting, Xiang Qin, Zhang Mei-Jun, Sun Xing-Lan

机构信息

Nursing Department, The Second Affiliated Hospital, Jiangxi Medical College, Nan Chang University, Min de Road #, Nan Chang, Jiang Xi, 330006, People's Republic of China.

School of Nursing, Jiangxi Medical College, Nan Chang University, Nan Chang, Jiang Xi, People's Republic of China.

出版信息

BMC Geriatr. 2024 Dec 19;24(1):1012. doi: 10.1186/s12877-024-05602-0.

Abstract

BACKGROUND

Although frailty is highly prevalent in hospitalized older heart failure (HF) patients, its management is often delayed. Understanding the unique experiences of frail elderly HF patients and the perceptions of healthcare professionals (HPs) regarding frailty can facilitate the integration of frailty prevention and intervention into clinical practice. This study aimed to use a descriptive qualitative approach to obtain the experiences of frailty in older HF patients and the perceptions of HPs concerning frailty.

METHODS

Qualitative interviews were conducted with 16 frail elderly HF patients and 13 healthcare providers. Data were analyzed using thematic analysis.

RESULTS

The interviews yielded several themes with associated subthemes: "a state of predicament," "hope is gone and social isolation," "daily adjustment and attempts to do something," "thoughts on factors contributing to frailty," "the need for transformation of stakeholders' mindset regarding frailty," "management is imperative, but there is still a way to go".

CONCLUSIONS

Both elderly patients with HF and HPs described frailty as a state of predicament, involving being caught in life difficulties and falling into a treatment dilemma. Due to the overlap of symptoms and evaluating indicators between frailty and HF, it's essential to thoroughly understand modifiable risk factors that could worsen frailty and develop a specific frailty assessment tool for HF patients. Adequate social support, multidisciplinary collaboration, and a frailty education program for patients, caregivers, and HPs are essential to facilitate frailty management and improvement.

摘要

背景

尽管衰弱在住院老年心力衰竭(HF)患者中非常普遍,但其管理往往被延迟。了解衰弱老年HF患者的独特经历以及医疗保健专业人员(HPs)对衰弱的看法,有助于将衰弱预防和干预纳入临床实践。本研究旨在采用描述性定性方法,以获取老年HF患者的衰弱经历以及HPs对衰弱的看法。

方法

对16名衰弱老年HF患者和13名医疗保健提供者进行了定性访谈。采用主题分析法对数据进行分析。

结果

访谈产生了几个主题及相关子主题:“困境状态”、“希望破灭与社会孤立”、“日常调整与尝试做事”、“对导致衰弱因素的看法”、“利益相关者对衰弱的思维模式需要转变”、“管理势在必行,但仍有很长的路要走”。

结论

老年HF患者和HPs都将衰弱描述为一种困境状态,包括陷入生活困难和陷入治疗困境。由于衰弱和HF之间症状和评估指标的重叠,必须彻底了解可能使衰弱恶化的可改变风险因素,并为HF患者开发特定的衰弱评估工具。充足的社会支持、多学科协作以及针对患者、护理人员和HPs的衰弱教育计划对于促进衰弱管理和改善至关重要。

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Frailty and prognosis of older patients with chronic heart failure.老年慢性心力衰竭患者的虚弱与预后。
Rev Esp Cardiol (Engl Ed). 2022 Dec;75(12):1011-1019. doi: 10.1016/j.rec.2022.04.016. Epub 2022 Jun 16.

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Frailty knowledge level and its influencing factors among older adults in China.中国老年人衰弱知识水平及其影响因素。
Geriatr Nurs. 2023 Mar-Apr;50:247-254. doi: 10.1016/j.gerinurse.2023.01.004. Epub 2023 Feb 19.

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