Shih F J, Huang L H
School of Nursing, National Taiwan University, Taipei, Republic of China.
Kaohsiung J Med Sci. 1996 Feb;12(2):114-27.
Little data are available concerning Taiwanese patients' needs and the factors contributing to their needs before cardiac surgery. The purpose of this study was to explore the components, nature and definition of patients' needs and their coping strategies of preparation for cardiac surgery during admission transition from patients' perspectives. The admission transition in this study means the patients' stay in the cardiovascular floor unit before surgery. Thirty adult patients (15 men, 15 women) having cardiac surgery were theoretically sampled from three hospitals in Taipei, Taiwan. Data were obtained through a semi-structured interview with the investigator and were analyzed by employing the combination of strategies from grounded theory, qualitative content analysis, linking data, and constant comparison. Ninety percent of participants expressed two types of needs: certain- including met, unmet and expectant needs, and uncertain needs. Needs that participants believed to have been met were the needs for security, maintaining daily living activities, understanding the surgery and recovery process, the needs for optimal physical condition for surgery, receiving quality treatment, and coaching as to use of medical instruments. The unmet needs were the needs for maintaining daily activities, security, fulfilling unfinished family responsibilities, financial support, understanding the surgery and what to expect during the recovery process, freedom from pain, family members' companionship, and spiritual support. The expectant needs included those needs during the ICU and discharge-preparation recovery transitions, throughout the hospitalization and after recovery. The components, nature, definition, reasons, and suggestions for patients' needs and their coping strategies were delineated and discussed. Finally, a conceptual framework was developed to describe and depict this phenomenon.
关于台湾患者心脏手术前的需求以及导致这些需求的因素，现有数据较少。本研究的目的是从患者角度探讨住院过渡期间心脏手术患者需求的构成、性质和定义，以及他们的术前准备应对策略。本研究中的住院过渡是指患者在手术前在心血管病房的停留。从台湾台北的三家医院理论抽样选取了30例接受心脏手术的成年患者（15名男性，15名女性）。通过与研究者进行半结构化访谈获取数据，并采用扎根理论、定性内容分析、关联数据和持续比较等策略相结合的方法进行分析。90%的参与者表达了两种需求：确定性需求——包括已满足的、未满足的和预期的需求，以及不确定性需求。参与者认为已满足的需求包括对安全的需求、维持日常生活活动的需求、了解手术和恢复过程的需求、处于最佳身体状况以进行手术的需求、接受优质治疗的需求以及关于医疗仪器使用的指导需求。未满足的需求包括维持日常活动的需求、安全需求、履行未完成的家庭责任的需求、经济支持需求、了解手术和恢复过程中预期情况的需求、免于疼痛的需求、家庭成员陪伴的需求以及精神支持需求。预期需求包括重症监护病房期间以及出院准备和恢复过渡期间、整个住院期间及恢复后的需求。阐述并讨论了患者需求及其应对策略的构成、性质、定义、原因和建议。最后，构建了一个概念框架来描述和刻画这一现象。
