Sebern M D
Division of Nursing, Alverno College, Milwaukee, WI 53234-3922, USA.
Res Nurs Health. 1996 Jun;19(3):183-92. doi: 10.1002/(SICI)1098-240X(199606)19:3<183::AID-NUR2>3.0.CO;2-G.
The purpose of this investigation was to render a more complete understanding of subjective perceptions of pressure ulcers from the perspective of family dyads, and to study the effect of these subjective experiences on preventive behaviors and pressure ulcer outcomes. A naturalistic inquiry, combined with objective measures, was used. Twenty-one dyads participated in four in-depth interviews to explore how they mentally represented and responded to the risk of pressure ulcers. Through the process of concept development, a lay representation of pressure ulcers was developed. This process produced a new concept, identified as "shared care," that explained how the dyad's interaction influenced preventive behavior. Shared care consists of three elements: communication of symptoms, decisions about how to respond to symptoms, and appraisals of reciprocity. Two contrasting patterns of care were identified: shared and directed/discrepant. In the shared care group, 10 patients were at risk for pressure ulcers but only 4 developed ulcers. In this discrepant care group, 3 patients were at risk and 2 developed pressure ulcers. Shared care was a pattern of interaction used successfully by family members to prevent pressure ulcers in patients at risk.
本调查的目的是从家庭二元组的角度更全面地理解对压疮的主观认知，并研究这些主观体验对预防行为和压疮结局的影响。采用了自然主义探究与客观测量相结合的方法。21个二元组参与了四次深入访谈，以探讨他们如何在心理上表征并应对压疮风险。通过概念发展过程，形成了压疮的外行表征。这一过程产生了一个新的概念，即“共享护理”，它解释了二元组的互动如何影响预防行为。共享护理由三个要素组成：症状沟通、关于如何应对症状的决策以及互惠评估。确定了两种截然不同的护理模式：共享型和指导/差异型。在共享护理组中，10名患者有发生压疮的风险，但只有4人发生了溃疡。在这个差异护理组中，3名患者有风险，2人发生了压疮。共享护理是家庭成员成功用于预防有风险患者发生压疮的一种互动模式。
