神经内科护士对脑卒中患者良肢位摆放认知的质性研究

Qualitative Study of Neurology Nurses’Cognition of Good Limb Placement in Patients with Cerebral Apoplexy

目的深入了解神经内科护士对脑卒中患者良肢位摆放的认知体验,并分析影响其开展效果的因素,为良肢位摆放在脑卒中患者高质量的实施提供参考。方法基于现象学研究方法,对郑州人民医院神经内科15名护理人员进行半结构式深入访谈,并对所得资料采用Colaizzi七步法进行整合分析。结果经过对访谈内容进行分类、编码、反思及提炼,共提炼一级主题3个,二级主题8个。主题一:良肢位摆放远期效果(降低卒中后并发症发生率、降低护理成本);主题二:影响良肢位摆放效果的障碍因素(患者及家属依从性较低、辅助支具不适宜、护士指导不明确);主题三:良肢位摆放开展建议(重视宣教、提高依从性、适当辅助支具、开展系统护理培训)。结论良肢位摆放能够有效改善脑卒中患者预后,促进其疾病转归,然而在开展过程中应重视患者及其家属疾病知识的掌握,提高患者遵医行为,做好护理人员相关培训等,以促进良肢位摆放在脑卒中患者中的高质量推进和应用。

Objective To deeply understand the cognitive experience of nursing staff in the department of neurology on good limb placement in stroke patients,and analyze the influencing factors of its implementation effect,so as to provide reference for the high quality implementation of good limb placement in stroke patients.Methods Based on the phenomenological research method,a semi-structured in-depth interview was conducted with 15 nursing staffs in the department of neurology of People’s Hospital of Zhengzhou,and the datas obtained were analyzed by Colaizzi’s seven-step method.Results After classifying,coding,reflecting and refining the interview contents,there were altogether 3 first-level themes and 8 second-level themes.Theme 1:long-term effect of good limb placement(reduce the incidence of complications after stroke and reduce nursing costs).Theme 2:obstacles affecting the effect of good limb placement(low compliance of patients and family members,inappropriate auxiliary braces,unclear guidance from nurses).Theme 3:suggestions on the placement of good limbs with high quality(pay attention to propaganda and education,improve compliance,appropriate auxiliary braces,carry out systematic nursing training).Conclusion Good limb placement can effectively improve the prognosis of stroke patients and promote the outcome of their diseases.However,in the process of development,attention should be paid to patients and their family members’knowledge of the disease,and relevant training of nursing staff should be done well,so as to further promote the high quality promotion and application of good limb placement in stroke patients.