基于扎根理论与需方视角的居家老年痴呆患者生存与照护现状的质性研究  

Qualitative research on the survival and care status of senile dementia patients at home based on grounded theory and demand-side perspective

作　　者：张瑞 刘彦朋 王燕 温暖 孟庆慧[3] ZHANG Rui;LIU Yanpeng;WANG Yan;WEN Nuan;MENG Qinghui(Weifang Nursing Vocational College,Shandong,Weifang 261041,China;Department of Anesthesiology,Weifang People’s Hospital,Shandong,Weifang 261000,China;School of Nursing,Weifang Medical University,Shandong,Weifang 261053,China)

机构地区：[1]潍坊护理职业学院,山东潍坊261041 [2]山东省潍坊市人民医院麻醉科,山东潍坊261000 [3]潍坊医学院护理学院,山东潍坊261053

出　　处：《中国医药科学》2023年第20期127-131,共5页China Medicine And Pharmacy

基　　金：潍坊护理职业学院青年科研基金项目(YQJ2021003);山东省职业教育教学改革研究项目(2022138);山东省潍坊市软科学研究计划项目(2021RKX116)。

摘　　要：目的从服务需求方视角下扎根于痴呆家庭,充分了解居家老年痴呆患者的生存现状及痴呆照护者的核心需求,为明确痴呆家庭刚需服务类型、探寻科学支持路径提供依据。方法以程序性扎根理论为依据,采用目的抽样法于2022年6-12月选取12个痴呆家庭,深入到痴呆家庭进行深度观察并对12名痴呆照护者进行半结构式深度访谈,运用Nvivo12对原始资料编码并进行分析。结果对所获原始资料逐一进行开放式编码、主轴编码、选择性编码,共得到的101个树状节点、15个范畴、4个主范畴、关系图进行比较分析,最终确定“专业医疗服务需求”“照护困难”“外界支持”3个核心范畴。结论缺乏专业医疗护理康复支持是居家老年痴呆患者及照护者的主要照护困难,基层医疗卫生机构痴呆相关专业医疗服务不够、三甲医院/专科医院资源下沉不够、利用不足是问题关键。Objective To ground on dementia families from the perspective of service demand-side,fully understand the living status of senile dementia patients at home and the core needs of dementia caregivers,and provide a basis for defining the types of essential services for dementia families and investigating scientific support paths.Methods On the basis of procedural grounded theory,a total of 12 dementia families from June to December 2022 were selected by purposive sampling method.In-depth observation was conducted in the dementia families and semi-structured in-depth interviews were conducted with 12 dementia caregivers.The original data were coded and analyzed by Nvivo12.Results Open coding,axial coding and selective coding were carried out on the original data one by one,and 101 tree nodes,15 categories,4 main categories and relationship diagrams were compared and analyzed.Finally three core categories were determined,which were"professional medical service demand","care difficulties"and"external support".Conclusion The lack of professional medical care and rehabilitation support is the main care difficulty for senile dementia patients and caregivers at home.The key problems are insufficient professional medical services related to dementia in grassroots medical and health institutions and insufficient grounding and utilization of resources in tertiary hospitals/specialized hospitals.

关 键 词：扎根理论 居家 老年痴呆 需求 

分 类 号：R473.2[医药卫生—护理学]