骨科大手术患者主要照顾者协同静脉血栓栓塞症预防体验的质性研究  

Experience of collaborative venous thromboprophylaxis in caregivers of patients undergoing major orthopedic surgery: a qualitative study

作　　者：王彦艳[1] 姚梁怡 陈鑫[2] 曹梦迪 WANG Yanyan;YAO Liangyi;CHEN Xin;CAO Mengdi(The First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000;School of Nursing and Health,Zhengzhou University)

机构地区：[1]郑州大学第一附属医院,河南郑州450000 [2]郑州大学护理与健康学院

出　　处：《天津护理》2024年第2期127-131,共5页Tianjin Journal of Nursing

基　　金：河南省教育厅高等学校重点科研项目计划(23B320008)。

摘　　要：目的:了解骨科大手术患者主要照顾者协同静脉血栓栓塞症(VTE)预防的真实体验,为临床VTE预防管理提供新思路。方法:采用现象学研究方法,选取2023年3月至6月河南省某三级甲等医院15名骨科大手术患者的主要照顾者进行面对面半结构式访谈,采用Colaizzi 7步分析法分析访谈资料。结果:共提炼5个主题,分别为静脉血栓栓塞症风险认知(感知静脉血栓栓塞症风险、增强延续性护理预防意识)、照顾者积极情绪体验(坚定协同预防信念、接受生活轨迹转变、渴望多元化知识获取途径)、预防行为增强(主动寻求照护支持、积极承担协同责任)、照护能力不足(不能有效应对疼痛、缺乏效果测评支持)及协同预防益处感知(满足个人价值需求、采取主动疾病预防行为)。结论:临床医护人员应关注主要照顾者积极的行为体验,将VTE预防与协同护理模式整合,在VTE预防管理过程中促成主要照顾者承担教育者角色,提高其协同护理和感知益处能力。Objective:To understand the real experience of collaborative venous thromboprophylaxis in caregivers of patients undergoing major orthopedic surgery,and to provide a new idea for clinical venous thromboprophylaxis management.Methods:Fifteen main caregivers of patients undergoing major orthopedic surgery were recruited from a Class A tertiary hospital in Henan province from March to July 2023.Semi-structured interviews were performed to collect data and Colaizzi′s 7-steps analysis was conducted to analyze the data.Results:Five themes regarding collaborative venous thromboprophylaxis were extracted including awareness of the risk of venous thromboembolism(perceiving the risk of venous thromboembolism,increased awareness of prolonged thrombosis prevention),caregivers′positive emotional experience(strong belief in collaborative prevention,acceptance of life refocusing,desire for diversified knowledge acquisition channels),enhanced preventive behavior(actively seeking care support and taking on collaborative responsibilities),lack of care capacity(unable to cope effectively with pain,lack of effect assessment support)and perceived benefits of collaborative prevention(meeting personal value needs and adopting proactive disease prevention behaviors).Conclusion:Clinical providers should focus on the positive behavior experiences of primary caregivers,integrate VTE prevention with the collaborative care model.In the process of prevention and management of VTE,the primary caregivers should be encouraged to assume the role of educators to improve their ability of collaborative care and perceived benefits.

关 键 词：骨科大手术 照顾者 协同护理 静脉血栓 质性研究 

分 类 号：R473.6[医药卫生—护理学]