Shih F J, Meleis A I, Yu P J, Hu W Y, Lou M F, Huang G S
National Taiwan University School of Nursing, National Taiwan University Hospital, Taipei, Republic of China.
Heart Lung. 1998 Mar-Apr;27(2):82-98. doi: 10.1016/s0147-9563(98)90016-4.
To explore patients' concerns during the admission transition to cardiac surgery.
A descriptive qualitative design.
Four hospitals in northern Taiwan, Republic of China.
A purposive sample consisting of 40 adult patients (20 men and 20 women) who planned to have cardiac surgery. Age range was 20 to 70 years (mean 50.1 years).
The types, levels, components, coping strategies, context, and conceptual framework of patients' concerns.
Data were collected through semistructured interviews, and then analyzed using qualitative content analysis.
Ninety percent of subjects (N = 36) reported two types of concerns: certain (80%) and uncertain (10%). Their certain concerns reflected three levels of concerns: "Caring about" or "Thinking about" (52%); "Worrying about" or "Being afraid of" (43%); and "Experiencing a mortal fear of" (30%), ordered from the weakest to the strongest. The components of patients' concerns were the process of recovery; hospital experiences, including maintaining daily activities, pain at admission, and expectant discomforts and disabilities in the intensive care unit; death; unfinished responsibilities and life goals, significant persons, and places; financial needs; and poor quality of care. Strategies developed to manage their concerns included (1) The use of person-focused effort (both cognitive and psychomotor), (2) Seeking help from others, including family members, friends, other patients, and health professionals, and (3) Turning to metaphysical power. The context for the phenomenon of Taiwanese subjects' concerns concerning cardiac surgery during the admission transition were "Being a person," resuming normality, and empowerment of self.
The types, levels, components, and coping strategies of patients' concerns during the admission transition to cardiac surgery were discovered and delineated. The background context and conceptual framework for the phenomenon also were developed from the data analysis to describe and depict this phenomenon.
探讨心脏手术入院过渡期患者的担忧。
描述性定性设计。
中国台湾北部的四家医院。
由40名计划接受心脏手术的成年患者（20名男性和20名女性）组成的目的抽样。年龄范围为20至70岁（平均50.1岁）。
患者担忧的类型、程度、组成部分、应对策略、背景及概念框架。
通过半结构化访谈收集数据，然后采用定性内容分析法进行分析。
90%的受试者（N = 36）报告了两种类型的担忧：确定的（80%）和不确定的（10%）。他们确定的担忧反映了三个程度的担忧：“关心”或“思考”（52%）；“担心”或“害怕”（43%）；以及“极度恐惧”（30%），从最弱到最强排列。患者担忧的组成部分包括康复过程；医院经历，包括维持日常活动、入院时的疼痛以及重症监护病房中预期的不适和残疾；死亡；未完成的责任和生活目标、重要的人和地点；经济需求；以及护理质量差。为应对担忧而制定的策略包括：（1）运用以人为主的努力（包括认知和心理运动方面）；（2）向他人寻求帮助，包括家庭成员、朋友、其他患者和医护人员；（3）求助于超自然力量。台湾受试者在心脏手术入院过渡期担忧这一现象的背景是“作为一个人”、恢复正常和自我赋权。
发现并描述了心脏手术入院过渡期患者担忧的类型、程度、组成部分及应对策略。还从数据分析中得出了该现象的背景和概念框架，以描述和刻画这一现象。
