摘要
目的 了解老年髋部骨折患者的衰弱感知与应对体验,从患者视角感受衰弱现况,为医护人员进行衰弱管理提供参考.方法 采用目的抽样法,选取2023年9-10月在同济大学附属第十人民医院住院的12例老年髋部骨折合并衰弱患者为研究对象.采用质性研究的现象学分析,对患者的衰弱感知和衰弱应对体验进行半结构式访谈.使用NVivo 11.0软件及Colaizzi 7步分析法整理分析访谈资料.结果 老年髋部骨折患者衰弱感知可归纳为4个主题:存在多维生理挑战(躯体老化、营养失衡、疼痛与睡眠紊乱);日常生活受限(躯体活动障碍、回避社交活动);心理负担沉重(疾病的不确定感、自我效能感低下、对于家庭的愧疚感);社会支持不足(适老化环境缺乏、医疗政策保障有限).老年髋部骨折患者的衰弱应对可归纳为2个主题:积极应对(自我开导、同伴支持、主动寻求相关知识与指导);消极应对(置之不理).结论 衰弱对老年髋部骨折患者的生理、心理、日常生活及社会状态带来多重负面影响,多数患者以积极的态度面对衰弱状态,但也有部分患者表现出消极倦怠的情绪态度.医务人员应重视老年髋部骨折患者衰弱感知,早期识别相关症状,发挥多方支持作用缓解衰弱患者的身心负担,鼓励患者乐观面对衰弱挑战,采取积极的措施延缓衰弱发展.
Abstract
Objective To understand the frailty perception and coping experiences of elderly patients with hip fractures from the patients'perspective,providing insights for healthcare professionals on managing frailty.Methods A purposive sampling method was used to select 12 elderly patients with hip fractures and frailty who were hospitalized at Tenth People's Hospital of Tongji University from September to October 2023.A phenomenological approach was adopted for this qualitative study,conducting semi-structured interviews to explore the patients'frailty perceptions and coping experiences.NVivo 11.0 software and Colaizzi's seven-step analysis method were used to organize and analyze the interview data.Results The frailty perceptions of elderly hip fracture patients were categorized into four themes:multidimensional physiological challenges(e.g.,aging of the body,nutritional imbalances,pain and sleep disturbances);limitations in daily life(e.g.,mobility impairments,avoidance of social activities);heavy psychological burdens(e.g.,uncertainty about the illness,low self-efficacy,feelings of guilt towards the family);insufficient social support(e.g.,lack of age-friendly environments and limited medical policy coverage).The patients'coping strategies were grouped into two themes:active coping(e.g.,self-encouragement,peer support,actively seeking relevant knowledge and guidance);passive coping(e.g.,neglecting the situation).Conclusions Frailty brings multiple negative impacts on the physical,psychological,daily life and social aspects of elderly hip fracture patients;while most patients adopt a positive attitude towards frailty,some exhibit signs of emotional exhaustion and passivity.Medical staff should pay attention to the frailty perceptions of elderly hip fracture patients,identify related symptoms early,provide comprehensive support to alleviate the physical and psychological burden,and encourage patients to face frailty challenges optimistically,adopting proactive measures to slow its progression.
维普
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