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了解残疾中风患者家庭照顾者的需求:一项运用适时理论的现象学研究。

Understanding the needs of family caregivers of stroke patients with disabilities: A phenomenological study using the timing it right theory.

作者信息

Wang Miaozhen, Wang Ke, Xie Bin, Liu Dan, Song Lingling, Cao Xing, Tong Yunhui, Liu Chenting, Fu Hongyu, Zhou You, Chen Qinqin, Zhu Yan, Zhu Ling, Cheng Fangqun

机构信息

Department of Nursing, Xiangtan Central Hospital, Xiangtan, China.

Xiangtan Medicine & Health Vocational College, Xiangtan, China.

出版信息

PLoS One. 2025 Jun 11;20(6):e0325671. doi: 10.1371/journal.pone.0325671. eCollection 2025.

Abstract

BACKGROUND

Stroke is a leading cause of disability worldwide, significantly impacting patients and their families. Family caregivers, as the primary providers of care for stroke patients, face dynamic and evolving challenges throughout the patient's recovery journey.

OBJECTIVE

This study aims to explore the comprehensive care needs of family caregivers of stroke patients with disabilities within the Chinese cultural context. The study is guided by the "Timing It Right" (TIR) theory, a conceptual model emphasizing dynamic support aligned with caregivers' evolving needs across distinct care phases.

METHODS

Using a phenomenological qualitative design, this study recruited 48 family caregivers of stroke patients with disabilities from a tertiary hospital in Xiangtan City, China, from February 2024 and November 2024. Data were collected through semi-structured interviews and were analyzed thematically using NVivo 12 software. This study explored caregivers' experiences and needs across five key phases of care: diagnosis, stabilization, discharge preparation, adjustment, and adaptation.

RESULTS

In this study, family caregivers of stroke patients with disabilities expressed diverse needs across different phases of the patient's illness. (1) Diagnosis phase: hospital environment adaptation, examination navigation and disease knowledge acquisition. (2) Stabilization phase: rehabilitation skill development and caregiver well-being support. (3) Discharge preparation phase: home care readiness and health behavior guidance. (4) Adjustment phase: sequelae management and care continuity needs. (5) Adaptation phase: obtaining follow-up resources and safety management. Caregivers' needs were influenced by cultural expectations(e.g., Chinese traditional filial piety norms requiring family-based caregiving), resource limitations, and their evolving role over time.

CONCLUSION

The findings emphasize the necessity of developing culturally sensitive interventions that are specifically tailored to meet the needs of family caregivers across distinct phases of care. Consideration should be given to integrating multidisciplinary teams, leveraging telemedicine for continuity of care, and designing caregiver education programs aligned with Confucian family values. These strategies can reduce caregiver burden and improve stroke rehabilitation outcomes in resource-limited settings.

摘要

背景

中风是全球致残的主要原因,对患者及其家庭产生重大影响。家庭照顾者作为中风患者的主要护理提供者,在患者的康复过程中面临着动态且不断变化的挑战。

目的

本研究旨在探讨中国文化背景下残疾中风患者家庭照顾者的综合护理需求。该研究以“适时介入”(TIR)理论为指导,这是一个概念模型,强调根据照顾者在不同护理阶段不断变化的需求提供动态支持。

方法

本研究采用现象学质性设计,于2024年2月至2024年11月从中国湘潭市一家三级医院招募了48名残疾中风患者的家庭照顾者。通过半结构化访谈收集数据,并使用NVivo 12软件进行主题分析。本研究探讨了照顾者在护理的五个关键阶段的经历和需求:诊断、病情稳定、出院准备、调整和适应。

结果

在本研究中,残疾中风患者的家庭照顾者在患者疾病的不同阶段表达了多样化的需求。(1)诊断阶段:适应医院环境、检查引导和疾病知识获取。(2)病情稳定阶段:康复技能培养和照顾者身心健康支持。(3)出院准备阶段:家庭护理准备和健康行为指导。(4)调整阶段:后遗症管理和护理连续性需求。(5)适应阶段:获取后续资源和安全管理。照顾者的需求受到文化期望(例如,中国传统孝道规范要求家庭照顾)、资源限制以及他们随时间演变的角色的影响。

结论

研究结果强调了制定具有文化敏感性干预措施的必要性,这些措施应专门针对不同护理阶段家庭照顾者的需求进行定制。应考虑整合多学科团队,利用远程医疗实现护理连续性,并设计符合儒家家庭价值观的照顾者教育项目。这些策略可以减轻照顾者负担,并改善资源有限环境中的中风康复效果。

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