宁夏地区血液透析患者社会支持的质性研究

目的探讨宁夏地区血液透析患者社会支持状况。方法目的抽样法选择宁夏某三甲医院血液透析中心患者90例,采用生存质量调查表(SF-36)进行问卷调查;选择其中15例患者进行访谈,访谈资料应用日本学者木下康仁的修正版扎根理论的质性研究方法(M-GTA)进行质的归纳性持续比较分析。结果宁夏地区血液透析患者生存质量各维度均低于正常人群(P<0.05);经M-GTA分析,社会支持提炼出1个大主题"回归社会的渴望",包含"珍惜生命""渴望关注"2个副主题。结论应为宁夏地区血液透析患者建立社会支持体系,改善血液透析患者生存质量,促进其回归社会。

Coping Process in Children with Food Allergies Developing during Early Childhood

This study aimed to clarify the coping process in children who developed food allergies in early childhood and evaluate the nursing support required to enable the acquisition of independent care behaviors in children with food allergies. Semi structured interviews were conducted on 24 children (aged 11 - 15 years) with food allergies using the modified grounded theory approach. The 11 categories were identified as coping mechanisms that these children used to deal with their early childhood food allergies. The coping process in children with food allergies involved transition from a stage of viewing their allergy with fear to a stage of considering the allergy as manageable and thus tackling allergens in their own way in the Life model. The process required obtaining peace of mind with support from others. In addition to emphasizing the threat of food allergies and risk aversion behaviors to these children, it is important that nurses also communicate viable proposals for alternative behaviors for the prohibited actions. The results also suggest that children in school age or older require support to help them recognize food allergy-related issues as problem-oriented coping tasks from the viewpoint of both Medical and Life models.

The Process of Support by Nursing Professionals for Families Having a Member with Borderline Personality Disorder

The purpose of this study was to explore the process of family support provided by nurses to families with a borderline personality disorder (BPD) patient. Semi-structured interviews were conducted with 16 nurses who had provided care to BPD patients. Data obtained from the interviews were qualitatively analyzed using a modified grounded theory approach. As an overall core category of family support processes practiced by nurses for families with BPD patients, family support practiced without awareness that the nurses were supporting families was extracted. Through this process, nurses held perceptions that were premises for family support, which were formed through their individual nursing experiences and perspectives. Nurses also had diverse perceptions concerning the image of families. Through the integration of perceptions that were premises for family support and perceptions of an image of the family, nurses underwent a process of “determination and ambivalence about the need for family support.” Then, nurses provided “family support practice” when they acknowledged the need for family support. During the “family support practice,” nurses had difficulties in providing family support. When family support was not successfully provided, nurses provided “family support practice with seeking more effective ways through trial and error.” For cases in which nurses did not acknowledge the need for intervention, they intentionally chose “not to provide family support.” Furthermore, during the “family support practice,” nurses had contradictory perspectives of family support. Such family support processes ultimately led to an awareness of the same family support required for the future. Family support was provided with “family support practice” and “family support practice with seeking more effective ways through trial and error.” In some cases, however, the process ended in “not to provide family support intentionally.” Experiences and perspectives in providing family support are important factors in carrying out future family support. Developing the positive implications of these factors and reducing psychological strain on nurses may ensure smooth implementation of family support. Thus, nurses need to recognize that they are supporting the family, which is identified as a core category.

Process of Patients Telling Children about Newly Diagnosed Breast Cancer

Objective: This study aims to determine the process of patients with newly diagnosed breast cancer in Japan telling their children about the disease, and how they have thought about it after the diagnosis. Methods: Semi-structured interviews were conducted with 15 patients with newly diagnosed breast cancer who had 3- to 14-year-old children. Narratives of participants about how they told their children about the disease were analysed by a qualitative and descriptive study design using the Modified Grounded Theory Approach (M-GTA). Results: In the process by which patients with newly diagnosed breast cancer tell their children about the disease, participants were [Maintaining mental balance in the face of the threat of the cancer] after the breast cancer diagnosis, and used the “Facing the cancer through the relationship with the children” as the core category in the process. The participants had [Determined to tell the children about the disease], while [Being worried about the influence of cancer on the children], [Thinking about the benefits of not hiding the cancer], and [Feeling difficulty in communicating the diagnosis of cancer to their children]. They were [Encouraged to tell about the disease to the children] by people around them, and did tell the children that they had a “disease” or “cancer”. The participants who told the children that they had the disease while [Determining the impact on the children] repeated the [Making herself look unconcerned] in the process. Those who told the children that they had cancer while [Determining the impact on the children] repeated [Talking openly about cancer and death] between parents and children. Conclusions: The participants came to face their own cancer by maintaining mental balance in the face of the threat of the cancer and telling their children about the disease. Nurses need to assist these patients to be able to deal openly with their children from the early stage of the diagnosis and solve problems by family members.

宁夏地区血液透析患者生存状态的质性研究

目的 探讨宁夏地区血液透析患者生存状态.方法 应用日本学者木下康仁的修正版扎根理论研究方法,对15名血液透析患者进行访谈,访谈资料用质的归纳性持续比较分析.结果 宁夏地区血液透析患者生存状态提炼出2个相对存在的主题＂无奈的透析人生＂＂回归社会的渴望＂,前者包含＂困顿生活＂＂易感心理＂2个副主题,后者包含＂珍惜生命＂＂渴望关注＂2个副主题.结论 建立社会支持体系,改善血液透析患者生命质量,促进回归社会.