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下肢截肢者及其家庭照顾者:挑战、需求与赋权策略——一项定性研究

Lower-Limb Amputees and Family Caregivers: Challenges, Needs, and Strategies for Empowerment-A Qualitative Study.

作者信息

Rodrigues Diana, Carvalho Luís, Pinto Cristina

机构信息

RISE-Health, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.

ICBAS-Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal.

出版信息

Nurs Rep. 2025 May 12;15(5):166. doi: 10.3390/nursrep15050166.

Abstract

Lower-limb amputation profoundly affects individuals and their family caregivers, particularly during home transition after hospital discharge. Understanding the needs, challenges, and emotions during this period is essential for designing effective family centered empowerment interventions. This study aimed to explore the lived experiences of amputees and their caregivers, identify their needs and challenges, and identify strategies to foster empowerment, resilience, and adaptation after amputation. : This qualitative, descriptive-exploratory study involved semi-structured interviews with 37 dyads, each comprising an amputee who has undergone major dysvascular lower-limb amputation and their primary caregiver, who provided home care. The participants attended follow-up consultations post-amputation. Data were collected over a 13-month period and analyzed using qualitative content analysis based on Bardin's methodology, with support from ATLAS.ti 23.3.4 software for coding and data organization. : Four categories emerged: (i) difficulties faced, including loss of autonomy, mobility challenges, architectural barriers, and emotional strain; (ii) home discharge, emphasizing functional training for amputees and caregivers and the need for community support; (iii) impact of amputation, highlighting acceptance difficulties, psychological distress, social isolation, and lifestyle changes; and (iv) empowerment strategies, focusing on psychological support, skills training, assistive devices, and coordinated care. Tailored interventions such as peer support, home adaptations, and multidisciplinary care are essential for resilience, independence, and improved quality of life. : Family centered empowerment strategies are vital for improving the outcomes of amputees and caregivers. Interventions that prioritize caregiver education, psychological support, and enhanced accessibility promote resilience, autonomy, and quality of life. These findings highlight the need for integrated hospital-to-community programs.

摘要

下肢截肢对患者及其家庭照顾者有深远影响,尤其是在出院后回家过渡期间。了解这一时期的需求、挑战和情绪对于设计有效的以家庭为中心的赋权干预措施至关重要。本研究旨在探索截肢者及其照顾者的生活经历,确定他们的需求和挑战,并确定促进截肢后赋权、恢复力和适应能力的策略。:这项定性的描述性探索性研究包括对37对受访者进行半结构化访谈,每对受访者包括一名接受过主要血管性下肢截肢的截肢者及其提供家庭护理的主要照顾者。参与者在截肢后参加了随访咨询。数据在13个月的时间内收集,并使用基于巴丁方法的定性内容分析法进行分析,在ATLAS.ti 23.3.4软件的支持下进行编码和数据整理。:出现了四类情况:(i)面临的困难,包括失去自主性、行动挑战、建筑障碍和情绪压力;(ii)出院,强调对截肢者和照顾者的功能训练以及社区支持的必要性;(iii)截肢的影响,突出接受困难、心理困扰、社会孤立和生活方式改变;(iv)赋权策略,侧重于心理支持、技能培训、辅助设备和协调护理。诸如同伴支持、家庭改造和多学科护理等量身定制的干预措施对于恢复力、独立性和改善生活质量至关重要。:以家庭为中心的赋权策略对于改善截肢者和照顾者的结局至关重要。优先考虑照顾者教育、心理支持和提高可及性的干预措施可促进恢复力、自主性和生活质量。这些发现凸显了综合医院到社区项目的必要性。

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