急性ST段抬高型心肌梗死行急诊冠状动脉介入术患者家属真实体验的质性研究

True Experience of Caregivers of Patients with ST-segment Elevation Myocardial Infarction Underwent Percutaneous Coronary Intervention:A Qualitative Study

目的探讨急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)行急诊冠状动脉介入术(percutaneous coronary intervention,PCI)治疗患者家属在早期就诊、PCI术前后、入住冠心病重症监护室(cardiac care unit,CCU)和普通病房等不同阶段的体验及需求。方法采用半结构式和Colaizzi现象学研究法多次访谈患者家属,并分析资料。结果 18名家属体验及需求归纳为:(1)急诊室阶段,惊恐与无助,震惊与自责,焦虑与担忧;(2)CCU阶段,担心照顾不周以及患者病情加重,渴望守护;(3)普通病房阶段,缺乏照护经验,告知病情态度不一,担忧未来,期待医护人员支持。结论家属在患者就医不同阶段的体验及需求不同,应根据不同阶段的需求提供有针对性的护理措施。

Objective To discuss the true experience of caregivers of patients with ST-segment elevation myocardial infarction （STEMI） underwent percutaneous coronary intervention （PCI） at the first episode of acute myocardial infarction （AMI）, before or after percutaneous coronary intervention in the cardiac care unit （CCU） and in the cardiology department. Methods The patients＇ caregivers were studied by semi- structured interview.Colaizzi phenomenology analysis was performed to analyze the data.Results Experi- ences and needs of 18 caregivers were classified as followed： 1.in emergency room：feel terrified and help- less, shocked and self-accusation, anxious and worried. 2.in the CCU：worried about the improper care and the aggravation of the illness, and eager to take care by themselves. 3. in the cardiology department：lack of caring experiences, worried about the future, faced with the difference ＂attitude towards the patients and looked forward to get support from the doctors and nurses.Conclusions The different emotion changes in the relatives of AMI patients suggested the importance of nurses＇ targeted and comprehensive care accord- ing to different needs.