Darwish Maram, Abdelgafar Katrin, Jackson Sian, Coulson James, Withers Kathleen, Bosanquet David C
Southeast Wales Vascular Network, University Hospital of Wales, Cardiff, UK.
Health Education England, East Midlands Deanery, Nottingham, UK.
Health Serv Insights. 2025 Jun 4;18:11786329251342283. doi: 10.1177/11786329251342283. eCollection 2025.
The complexity of treatment pathways and the chronic nature of diseases in vascular surgery necessitate a patient-centred approach to improve care quality and health outcomes.
To explore vascular patients' experiences, identifying key factors influencing their satisfaction and adherence to treatment.
Qualitative design using thematic analysis.
Seventeen semi-structured interviews were conducted with vascular patients (10 males and 7 females) from 3 vascular units in Wales. Proportional random sampling was used for participant selection based on recent vascular care, age, sex, and clinical backgrounds. Interviews were conducted in person, recorded, and transcribed verbatim. Thematic analysis was employed to identify key themes. NVivo 10 software facilitated data management.
Six themes were identified: (i) communication and information delivery, (ii) patient involvement in decision-making, (iii) pain management, (iv) psychological and emotional support, (v) healthcare environment and systemic processes and (vi) continuity of care and post-discharge experience. While patients generally appreciated the professionalism of the healthcare staff, notable disparities emerged in communication, particularly for patients with lower health literacy or during waiting periods. Inconsistencies in discharge planning and follow-up care highlighted systemic inequities. Across all units, patients reported a lack of formal psychological support. Involvement in decision-making varied, with some patients feeling adequately included, while others experienced exclusion and anxiety.
These findings reveal key areas for improvement, with communication serving as a foundational element that enhances patient involvement in decision-making, psychological support, and continuity of care. Addressing these interconnected areas, with a focus on effective communication and health equity, may help close care gaps and improve outcomes for all vascular patients.
血管外科治疗路径的复杂性和疾病的慢性性质需要以患者为中心的方法来提高护理质量和健康结果。
探讨血管疾病患者的经历，确定影响其满意度和治疗依从性的关键因素。
采用主题分析的定性设计。
对来自威尔士3个血管科的血管疾病患者（10名男性和7名女性）进行了17次半结构化访谈。根据近期血管护理情况、年龄、性别和临床背景，采用比例随机抽样法选择参与者。访谈采用面对面的方式进行，进行录音并逐字转录。采用主题分析法确定关键主题。NVivo 10软件有助于数据管理。
确定了六个主题：（i）沟通与信息传递，（ii）患者参与决策，（iii）疼痛管理，（iv）心理和情感支持，（v）医疗环境和系统流程，以及（vi）护理连续性和出院后体验。虽然患者普遍赞赏医护人员的专业精神，但在沟通方面出现了明显差异，特别是对于健康素养较低的患者或在等待期间。出院计划和后续护理的不一致突出了系统性不平等。在所有科室，患者都表示缺乏正式的心理支持。参与决策的情况各不相同，一些患者感觉得到了充分的参与，而另一些患者则感到被排斥和焦虑。
这些发现揭示了需要改进的关键领域，沟通是增强患者参与决策、心理支持和护理连续性的基础要素。关注这些相互关联的领域，重点是有效的沟通和健康公平，可能有助于缩小护理差距并改善所有血管疾病患者的治疗结果。
