- 期刊
Patients' Needs and Their Coping Strategies Transition to Cardiac Surgery
心臟手術病人於術前住院期間的需要及其因應策略
摘要
台灣病人在接受心臟手術前，對恢復的準備工作至今仍所知有限。本研究為一大型研究計劃的一部份。透過半結構式訪談與作者所創之綜合”紮根理論”（grounded theory）、”內容分析”、”資料連接”與”經常比較法”之質性分析法，首次自病人的角度探討病人在心臟手術前住院期間的需要（含內容、性質與定義）及其因應策略，以協助護理品質。本研究採”紮根理論”之”理論取樣法”（theoretical sampling）自台灣北部三家醫院接受心臟手術之患者取樣30名（15名男性，15名女生）。研究發現90％即將接受心臟手術的個案在住院期間有下列二類需要：已確定之需要（含已被滿足、未被滿足與預期性需要）與未確定之需要。已被滿足之需要包括安全、維持日常生活、了解手術與恢復過程、預備術前最佳身體狀況、接受高品質醫療、與使用醫療儀器之指導。未被滿足之需要包括維持日常生活、安全、完成未竟之家庭責任、經濟支持、了解手術何為應期待之恢復過程、免於疼痛、家屬之陪伴、與靈性支持。個案之預期性需要涵括下列四階段：術後加護病房期、術後病房期、全部住院期、與恢復後階段。病人需要的內容、性質、定義、理由與對護理人員的建議亦被討論。最後，一代表台灣病人在心臟手術前住院期間的需要及其因應策略的概念架構亦自研究中發展出來。
關鍵字
無資料並列摘要
Little data are available concerning Taiwanese patients' needs and the factors contributing to their needs before cardiac surgery. The purpose of this study was to explore the components, nature and definition of patients' needs and their coping strategies of preparation for cardiac surgery during admission transition from patients' perspectives. The admission transition in this study means the patients' stay in the cardiovascular floor unit before surgery. Thirty adult patients (15 men, 15 women) having cardiac surgery were theoretically sampled from three hospitals in Taipei, Taiwan. Data were obtained through a semistructured interview with the investigator and were analyzed by employing the combination of strategies from grounded theory, qualitative content analysis, linking data , and constant comparison. Ninety percent of participants expressed two types of needs: certain- including met, unmet and expectant needs, and uncertain needs. Needs that participants believed to have been met were the needs for security, maintaining daily living activities, understanding the surgery and recovery process, the needs for optimal physical condition for surgery, receiving quality treatment, and coaching as to use of medical instruments. The unmet needs were the needs for maintaining daily activities, security, fulfilling unfinished family responsibilities, financial support, understanding the surgery and what to expect during the recovery process, freedom from pain, family members' companionship, and spiritual support. The expectant needs included those needs during the ICU and discharge-preparation recovery transitions, throughout the hospitalization and after recovery. The components, nature, definition, reasons, and suggestions for patients' needs and their coping strategies were delineated and discussed. Finally, a conceptual framework was developed to describe and depict this phenomenon.