2型糖尿病患者对基于App"医院-社区-家庭"联动的延续护理需求的质性研究

A qualitative study of the continuous nursing needs of patients with type 2 diabetes based on the App and hospital-community-family linkage

目的了解患者对基于App"医院-社区-家庭"联动的延续护理的相关需求。方法采用描述性质性研究的方法,对2020年1-2月在上海市浦东新区公利医院或社区医院就诊的15例2型糖尿病患者进行半结构式访谈,应用主题分析法并借助NVivo 10.0软件对资料进行整理分析。结果共提炼出5个主题:希望接受"医院主导,社区实施,家庭支持"的延续护理模式服务;希望提供适当、便捷、个性化的信息获取途径及随访方式;期待接受持续的全方位、专业化的健康指导;期望接受以糖尿病专科护士为主导,多学科团队共同管理的延续护理服务方式;期望糖尿病App简便实用、满足出院后病情监测、评估反馈、健康教育、健康干预的护理需求,能够保障个人隐私、免费使用。结论患者对接受基于App"医院-社区-家庭"联动的延续护理具有较强意愿。应建立分工明确的"医院-社区-家庭"联动的延续护理服务机制,加强多学科合作,借助团队优势为患者提供全面、专业、具备循证依据的延续护理服务,进一步优化软件功能,注重信息安全建设、遵循循证指南规范App内容,以满足患者需求。

Objective To understand the continuing care needs of patients based on the App and"hospital-community-home"linkage.Methods With descriptive qualitative research,a semi-structured in-depth interview was conducted in 15 patients with type 2 diabetes in Gongli Hospital,Pudong New Area,Shanghai City,and community hospital from January to February 2020.Thematic analysis and the software NVivo 10.0 were used for data analysis.Results Five themes were extracted:desire a"hospital-led,community-implemented,family-supported"model of continuing care;desire an appropriate,convenient and personalized access to information and follow-up;expect continuous,comprehensive,professional health guidance;expect to receive continuing care service led by specialized nurses and managed by multidisciplinary team;expect diabetes App to be simple and practical,satisfying various needs such as post-hospitalization condition monitoring,assessment feedback,health education and health intervention,ensure information security and free use.Conclusions Patients have a strong willingness to receive continuing care based on the App and"hospital-community-family"linkage.A mechanism of"hospital-community-family"linkage continuing care service with clear division of labor should be established,multidisciplinary cooperation should be strengthened,and team advantages should be utilized.Providing comprehensive,professional and evidence-based continuing care services for patients,while further optimizing software functions and focusing on information security construction and following evidence-based guidelines to standardize App content in order to adapt to more patient characteristics and needs.