中华护理杂志2024,Vol.59Issue(21) :2620-2626.DOI:10.3761/j.issn.0254-1769.2024.21.009

中年脑卒中患者康复锻炼生态瞬时评估影响因素的质性研究

A qualitative study of the influencing factors of ecological momentary assessment of rehabilitation exercise in middle-aged stroke patients

谭雨婷 张志霞 杨振 乔林茹 程蓉 陈秋霞 陈兰姣 肖琴 姜芳
中华护理杂志2024,Vol.59Issue(21) :2620-2626.DOI:10.3761/j.issn.0254-1769.2024.21.009

中年脑卒中患者康复锻炼生态瞬时评估影响因素的质性研究

A qualitative study of the influencing factors of ecological momentary assessment of rehabilitation exercise in middle-aged stroke patients

谭雨婷 1张志霞 1杨振 2乔林茹 2程蓉 3陈秋霞 1陈兰姣 1肖琴 1姜芳1
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作者信息

  • 1. 430064 武汉市 武汉科技大学附属天佑医院护理部
  • 2. 430064 武汉市 武汉科技大学附属天佑医院康复医学科
  • 3. 武汉科技大学医学部
  • 折叠

摘要

目的 探究对中年脑卒中患者康复锻炼实施生态瞬时评估(ecological momentary assessment,EMA)的影响因素,为脑卒中精准康复护理的决策和实践提供依据.方法 采用描述性质性研究方法,通过目的抽样法于2024年1月2日-3月10日选取武汉市某三级甲等综合医院8名医护人员、4名信息技术人员、8例中年脑卒中患者及5名照顾者为研究对象,以创新扩散理论为框架进行半结构式访谈,运用定向内容分析法分析资料.结果 提炼出相对优势因素(辅助医护人员精准动态评估患者康复行为及症状轨迹;增强患者自我管理意识,有效降低照顾负担),兼容性因素(新方法与现存认知相冲突;新方法与临床工作实践相契合),复杂性因素(评估频率影响康复追踪的准确性;肢体功能受限和社会支持不足增加用户使用负担),可试验性因素(试点与实时反馈可提高用户体验;经验总结与推广,强化实践验证导向),可观察性因素(移动医疗的成功案例,助力新方法普及;可视化呈现康复成效,丰富移动医疗实践)5个主题及10个亚主题.结论 在中年脑卒中患者居家康复锻炼领域实施EMA存在一定促进及阻碍因素,未来需挖掘EMA在精准康复领域的潜力,确保其与临床实践相契合.

Abstract

Objective To explore the influencing factors of ecological momentary assessment(EMA)in the implementation of home rehabilitation exercise for middle-aged stroke patients,and to provide a basis for decision-making and practice of precision rehabilitation nursing for stroke.Methods This descriptive qualitative research utilized purposive sampling method to select 8 medical staff,4 information technicians,8 middle-aged stroke patients,and 5 caregivers from a tertiary A general hospital in Wuhan from January 2 to March 10,2024 as the research subjects.Semi-structured interview was conducted based on the framework of diffusion of innovations theory.The data were analyzed using directed content analysis.Results 5 themes and 10 sub-themes were extracted,including relative advantage factors(conducive to precise and dynamic evaluation of patient rehabilitation behavior and symptom trajectory by medical staff;enhancing patient self-management awareness,effectively reducing care burden),compatibility factors(new methods conflict with existing values;new methods are in line with clinical work practice),complexity factors(evaluation frequency affects the accuracy of rehabilitation tracking;limited limb function and social support increase user burden),experimental factors(pilot and real-time feedback improve user experience;experience summary and promotion,the strengthening of practical verification orientation),and observable factors(successful cases of mobile health help popularize new methods;visualization of new methods to enrich mobile health practice).Conclusion There are certain promoting and hindering factors in the implementation of EMA in the field of home rehabilitation exercise for middle-aged stroke patients.In the future,it is necessary to explore the potential of EMA in the field of precision rehabilitation and ensure its compatibility with clinical practice.

关键词

中年/脑卒中/康复锻炼/生态瞬时评估/影响因素分析/质性研究/康复护理

Key words

Middle-Aged/Stroke/Rehabilitation Exercise/Ecological Momentary Assessment/Root Cause Analysis/Qualitative Study/Rehabilitation Nursing

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出版年

2024
中华护理杂志
中华护理学会

中华护理杂志

CSTPCD北大核心
影响因子:5.365
ISSN:0254-1769
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