气管切开患儿照顾者居家照护体验的质性研究
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摘要
目的探讨长期气管切开患儿照顾者的居家照护体验。方法采用半结构式访谈法,访谈13名照顾者,并依据Miles和Hurberman提出的质性研究资料分析法予以分析。结果经不断分析比对,共析出长期气管切开照顾者"照护负荷"、"精神困扰"及"益处发现"3个主题;"从束手无策到熟练掌握"、"亲职角色改变"、"社交隔离"等8个亚主题。结论临床工作者通过了解长期气管切开照顾者的照护体验,了解其身心反应、照护需求等。可在长期气管切开患儿入院时即构建个性化的延续护理方案,合理安排其出院后日常生活;培训照顾者各项专业操作,训练其心理调适技巧,而且可通过挖掘其自身资源促进照顾者体验积极心理变化等,以实现良好心理适应;促进患儿康复,提高其生活质量。
Objective To explore the home nursing care experience of caregivers of children with tracheostomy.Methods There were 13 caregivers evaluated by using semi-structured interview method,and analyzed according to Miles and Hurberman method.Results Three main themes were extracted including care load,mental distress and benefits finding and eight sub themes,including from helpless to master,parenting roles change,social isolation and so on.Conclusion Clinical professionals get to know children with tracheostomy's caregivers' physical and mental reactions,as well as care requirements through knowing their home nursing care experience,so that they can establish a personalized care program at the time when chilrdren are hospitalized;reasonablely arrange for their daily life after discharge,and training professional operation,and traintheir psychological adjustment skills,but also can promote to find own resources to experience positive changes,thus to establish good psychological adjustment,and to promote recovery and improve their quality of life.
Objective To explore the home nursing care experience of caregivers of children with tracheostomy.Methods There were 13 caregivers evaluated by using semi-structured interview method,and analyzed according to Miles and Hurberman method.Results Three main themes were extracted including care load,mental distress and benefits finding and eight sub themes,including from helpless to master,parenting roles change,social isolation and so on.Conclusion Clinical professionals get to know children with tracheostomy's caregivers' physical and mental reactions,as well as care requirements through knowing their home nursing care experience,so that they can establish a personalized care program at the time when chilrdren are hospitalized;reasonablely arrange for their daily life after discharge,and training professional operation,and traintheir psychological adjustment skills,but also can promote to find own resources to experience positive changes,thus to establish good psychological adjustment,and to promote recovery and improve their quality of life.
引文
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[7]Zhang W,Yan T T,Barriball K L,et al.Post-traumatic growth in mothers of children with autism:A phenomenological study[J].Autism,2015,19(1):29-37.
[8]Kirk S,Glendinning C.Supporting‘expert’parentsprofessional support and families caring for a child with complex health care needs in the community[J].Int J Nurs Stud,2002,39(6):625-635.
[9]武艳,赵玲玲,高伟,等.PICC带管肿瘤患儿照顾者家庭护理体验的质性研究[J].中国实用护理杂志,2016,32(12):925-928.
[10]Montagnino B A,Mauricio R V.The child with a tracheostomy and gastrostomy:Parental stress and coping in the home-a pilot study[J].Pediatr Nurs,2004,30(5):373-380,401.
[11]Hopkins C,Whetstone S,Foster T,et al.The impact of paediatric tracheostomy on both patient and parent[J].Int J Pediatr Otorhinolaryngol,2009,73(1):15-20.
[12]Tedeschi R G,Calhoun L G.Beyond the concept of recovery:Growth and the experience of loss[J].Death Stud,2008,32(1):27-39.
[13]巩树梅,董超群,梁珍红,等.意外创伤者反刍性沉思水平及影响因素的调查研究[J].中华护理杂志,2015,50(1):88-91.
[2]Pandian V,Garg V,Antar R,et al.Discharge education and caregiver coping of pediatric patients with a tracheostomy:Systematic review[J].ORL Head Neck Nurs.2016,34(1):17-18,20-27.
[3]Flynn A P,Carter B,Bray L,et al.Parents’experiences and views of caring for a child with a tracheostomy:A literature review[J].Int J Pediatr Otorhinolaryngol,2013,77(10):1630-1634.
[4]Joseph R A.Tracheostomy in infants:Parent education for home care[J].Neonatal Netw,2011,30(4):231-242.
[5]Woodgate R L,Edwards M,Ripat J.How families of children with complex care needs participate in everyday life[J].Soc Sci Med,2012,75(10):1912-1920.
[6]迈尔斯,休伯曼.质性资料的分析:方法与实践[M].重庆:重庆大学出版社,2008,5-38.
[7]Zhang W,Yan T T,Barriball K L,et al.Post-traumatic growth in mothers of children with autism:A phenomenological study[J].Autism,2015,19(1):29-37.
[8]Kirk S,Glendinning C.Supporting‘expert’parentsprofessional support and families caring for a child with complex health care needs in the community[J].Int J Nurs Stud,2002,39(6):625-635.
[9]武艳,赵玲玲,高伟,等.PICC带管肿瘤患儿照顾者家庭护理体验的质性研究[J].中国实用护理杂志,2016,32(12):925-928.
[10]Montagnino B A,Mauricio R V.The child with a tracheostomy and gastrostomy:Parental stress and coping in the home-a pilot study[J].Pediatr Nurs,2004,30(5):373-380,401.
[11]Hopkins C,Whetstone S,Foster T,et al.The impact of paediatric tracheostomy on both patient and parent[J].Int J Pediatr Otorhinolaryngol,2009,73(1):15-20.
[12]Tedeschi R G,Calhoun L G.Beyond the concept of recovery:Growth and the experience of loss[J].Death Stud,2008,32(1):27-39.
[13]巩树梅,董超群,梁珍红,等.意外创伤者反刍性沉思水平及影响因素的调查研究[J].中华护理杂志,2015,50(1):88-91.