阿尔茨海默病患者照护现况的质性研究

A qualitative study on the current situation of nursing care for Alzheimer's disease patients

目的了解阿尔茨海默病(AD)患者照护现况,探讨其照护模式改革。方法2018年1—4月,采用目的抽样法,选取成都市某三甲医院老年科和神经内科、精神专科医院、社区卫生服务中心的12名医务人员、19名AD患者及家属为研究对象。采用半结构式访谈,将获得的资料用Colaizzi现象学分析方法进行分析。结果访谈结果分为医疗护理服务、分级照护要素、患者及家属照护需求相关的3个主题。不同等级医疗机构医疗护理服务各有侧重;不同疾病时期的患者照护需求各异;照护要素涵盖生物、心理、社会维度。结论应重视AD疾病的早期筛查,早期介入认知康复训练;循证构建AD急性-中期-长期全程照护体系;开发AD长期护理保险,精准服务患者。

Objective To investigate the current status of nursing care for patients with Alzheimer's disease (AD) in China in order to explore the reform of its care model. Methods From January to April 2018, 12 medical staff, 19 patients with AD and their families from the Departments of Geriatrics and Neurology in a ClassⅢ Grade A hospital in Chengdu, psychiatric hospitals and community health service centers were selected as the research objects by purposive sampling. Semi-structured interviews were conducted, the data obtained was analyzed by Colaizzi phenomenological analysis method. Results The results of the interview were divided into three themes: medical care, hierarchical care elements, and the needs of patients and their families. Medical and nursing services in different levels of medical institutions have different emphasis;patients' care needs vary in different periods of illness;care elements cover biological, psychological and social dimensions. Conclusions Attention should be paid to early screening of AD diseases, early intervention in cognitive rehabilitation training, evidence-based construction of acute-medium-long-term care system for AD, and development of long-term care insurance for AD to serve patients accurately.