基于时机理论对肠造口患者照顾者不同阶段照护体验的质性研究

Caring experiences of family caregivers of patients with enterostomy in different stages based on “Timing It Righ”framework: a qualitative study

目的以时机理论为框架,了解肠造口患者照顾者在照护过程中的照护体验,为设计和实施能满足照顾者需求的有效干预提供依据。方法基于时机理论,选择40名处于不同照护阶段(围手术期、出院准备期、调整期和适应期)的患者照顾者,采用质性研究中的现象学研究方法,进行非结构访谈,并以Colaizzi现象学研究法分析资料,提炼主题。结果提炼出5个关于肠造口患者照顾者不同阶段照护体验的主题,(1)围手术期:疾病不确定感、创伤后应激障碍;(2)出院准备期:无助感;(3)调整期:实践与再认知;(4)适应期:创伤后成长。结论肠造口患者照顾者体验是一个动态变化的过程,且在不同阶段的内心照护体验和需求各有不同。患者照顾者在围手术期侧重信息和情感需求;在出院准备期具有较强的无助感;调整期侧重造口护理产品信息的需求;适应期侧重照顾能力的提高。应分阶段、有计划地给予肠造口患者照顾者相应的心理支持与提供信息资源的支持及相关知识的指导,从而提高其心理健康水平、照护知识和技能。

Objective To investigate the caring experiences of family caregivers of patients with enterostomy in different stages based on"Timing It Righ"framework.Method Phenomenological research method was used to conduct an unstructured interview with40caregivers of patients in different stages(perioperative period,discharge preparation period,adjustment period and adaptation period).The acquired data were analyzed by Colaizzi phenomenological research method.Result According to the"Timing It right"framework,five themes about nursing experience of caregivers of patients with enterostoma at different stages were extracted:1)uncertainty of disease and post-traumatic stress disorder at the perioperative period;2)Re-challenges after subjective initiative adjustment during the discharge preparation period;3)practice and re-cognition during the adjustment period;4)post-traumatic growth during the adaptation period.Conclusions The caregiver's experience of an enterostomal patient presents a dynamic process.There are different experiences and needs for inner-heart care in different stages.Family caregivers were with strong information and emotion need at the perioperative period;they were with strong helpless feeling during the dischsrge preparation;they were with information and stoma instrument need in adjustment period;they were with care ability need during adaption period.Nursing staff should provide relevant mental support and professional guidance up to the different stages so as to improve mental health of caregivers of stoma patients and enhance their knowledge and skills on care-giving.