失能老年人主要照护者感受及需求层次的质性研究

对2021年1月～2月15名失能老年人的主要照护者进行半结构化访谈,并从马斯洛需求层次理论的视角出发,分析结果。共归纳出5个主题：维持原有生活习惯的需求;缓解照护负担的需求;爱与归属的需求;获得失能老人尊重的需求;活动参与的需求;5个主题能分别对应马斯洛需求层次理论的5个层级且可整合为缺乏性需求和成长性需求两大类。相对于缺乏性需求,照护者成长性需求对其行为有更为持久的激励作用,且表现形式独特,应给予针对性干预。开展家庭护理对话及喘息服务等创新服务模式,是提高照护双方生活质量的有效策略。     

躯体化症状患者求医体验的质性研究

探索躯体化症状患者的病症感知及其求医过程体验、疾病相关的认知及态度的变化。应用半结构式深入访谈法,访谈12名躯体化症状为主诉的临床心理科患者;并对访谈资料进行录音、转录。转录资料依据诠释现象学分析法进行分析。结果归纳出躯体化症状患者求医体验的三个核心主题:与症状引发的困惑,症状对当下生活的影响,及曲折的诊疗经历。研究提示躯体化症状患者的病症体验具有\"具身\"属性,专业人员在干预中应关注其自我解释系统,提高患者的确定感及自主性。     

晚期肺癌化疗患者叙事护理体验的质性研究

对2021年1月～10月15名接受过为期2个月叙事护理的晚期肺癌化疗患者进行半结构式深入访谈,采用内容分析法归纳提炼主题,共归纳出3个主题：疗愈身心（减轻心理痛苦、缓解身体症状）;改变认知理念（对疾病的接纳、对自我意识的强化、自我反思）;提升生命意义感（征服对死亡的恐惧、支持性关系、浸入式意义体验）。在晚期肺癌化疗患者中实施叙事护理,能够从身体-心理-社会-精神四个维度促进患者成长,为肿瘤末期患者生命意义感的提升提供了新视角。     

家属ICU后综合征症状体验的质性研究

探讨了ICU患者家属在亲人入住ICU期间的真实体验,通过对18位家属进行半结构式访谈,运用主题分析法提炼出3个主题：家属存在多层面家属ICU后综合征（post-intensive care syndrome-family,PICS-F）症状感知（心理层面、生理层面、社会层面）;家属在PICS-F症状认知方面存在不足（自我忽视、健康过度关注）;家属在面对PICS-F症状时的应对方式多样（以情绪为中心型应对、以问题为中心型应对、回避型应对）。研究建议医务人员应深入关注这些症状的本质,提升家属PICS-F症状的认知水平,帮助他们改善应对方式,以有效缓解ICU后综合征相关症状,改善家属的整体健康状况。     

非识字高龄患者住院中的需求对策相关性研究

探讨患者的需求与对策。应用会谈法收集资料,教育患者认知所患疾病相关知识、帮助患者和家属适应住院环境、支持家属对患者的生活护理、缓解患者心理紧张情绪、协助患者遵从医疗护理服务行为、照顾患者口服用药过程、满足患者治疗过程中的需求、加强护理操作周边作业的督导,进而提出了满足需求对策的依据。     

非识字高龄患者住院中的需求对策相关性研究

探讨患者的需求与对策.应用会谈法收集资料,教育患者认知所患疾病相关知识、帮助患者和家属适应住院环境、支持家属对患者的生活护理、缓解患者心理紧张情绪、协助患者遵从医疗护理服务行为、照顾患者口服用药过程、满足患者治疗过程中的需求、加强护理操作周边作业的督导,进而提出了满足需求对策的依据.     

神经外科护士对开颅术患者手术压疮护理体验的质性研究

深入了解神经外科病房护士针对开颅术患者预防及护理手术压疮过程中所面临的问题及真实护理体验。以《定性研究统一报告标准：个体访谈和焦点组访谈的32项清单》为指导,采用质性研究中的现象学方法对8名神经肿瘤外科护士（师）进行一对一的半结构式访谈。共提炼3个主要概念：病房护士预见性护理评估很关键;缺乏科学有效的手术压疮风险评估工具;术后压疮护理措施实施有难度等,共8个次要概念。对手术压疮患者高危因素的识别及风险评估工具的应用,还需护理管理者及决策者作进一步的规范和研究。     

抑郁障碍患者心理治疗感受的质性研究

探索抑郁障碍患者在心理治疗前后及其过程中的内心体验.使用立意取样法选9倒抑郁患者,深入访谈法收集资料,Colaizzi法分析资料.结果显示:(1)发病前压力大,对心理治疗基本没概念;(2)心理治疗过程中喜忧掺半:既有正性的感受,又有负性的感受;(3)经济压力大;(4)对医院和学校不满;(5)对疾病有痛耻感.因此,社会需要加大心理卫生知识的普及,抑郁障碍患者需要深切的人文关怀,医生应努力为患者减轻病耻感,同时要注意其社会功能的恢复.     

抑郁障碍患者心理治疗感受的质性研究

探索抑郁障碍患者在心理治疗前后及其过程中的内心体验。使用立意取样法选9例抑郁患者,深入访谈法收集资料,Colaizzi法分析资料。结果显示:(1)发病前压力大,对心理治疗基本没概念;(2)心理治疗过程中喜忧掺半:既有正性的感受,又有负性的感受;(3)经济压力大;(4)对医院和学校不满;(5)对疾病有病耻感。因此,社会需要加大心理卫生知识的普及,抑郁障碍患者需要深切的人文关怀,医生应努力为患者减轻病耻感,同时要注意其社会功能的恢复。     

中国丧亲个体社会支持体验的质性研究

本研究通过对28位丧亲者进行深度访谈,使用解释现象学分析法对质性数据进行分析,探索中国丧亲个体的社会支持体验。结果显示,丧亲社会支持的内容包括后事处理、情感支持、生活恢复帮助,经济与物资支持等。支持来源除家人和朋友之外,还包括同事、相同经历者,以及相关机构等。社会支持通过调节情绪、改变认知等方式促进个体对丧亲的适应。本研究结果为最新丧亲社会支持模型提供了支持,同时也反映出中国社会对丧亲人群的社会支持特色。     

Incongruent Perceptions Among Nurses and Patients: A Qualitative Study of Patient's Dignity in Iran

Dignity is the most fundamental right of every human being, patients in particular. Despite being a fairly disputed concept, dignity is a multidimensional issue, the interpretation of which is affected by a multitude of factors. Semistructured interviews and observation data from 35 patients, their companions, and nurses were performed to highlight their views with regard to patients’ dignity in health care centers. Although findings reveal that nearly all patients felt that their dignity had been violated, there is a considerable difference between participants’ viewpoints of dignity. Interactions among participants can increase their awareness of dignity and may lead to its maintenance.     

Stigma and Ostracism Associated with HIV/AIDS: Children Carrying the Secret of Their Mothers' HIV+ Serostatus

Qualitative interviews were conducted with mothers (N = 47) who had disclosed their HIV status to their children. The majority of mothers explicitly told their child not to disclose to other people that she was HIV-positive because they feared repercussions in the way of stigma and ostracism for both themselves and their child. Approximately one-fourth of the mothers identified safe people, to whom their child could discuss her serostatus, such as family members, health care providers, or therapists. The majority of the children respected their mothers' wishes; only four children disclosed to someone after being explicitly told not to do so. A significant number of children expressed concerns about their friends finding out, fearing that they would be ostracized or that it would be assumed they were also infected. In addition, the children did not want others to find out because they wanted to protect their mothers. The burden of keeping the secret of their mothers' serostatus does seem to be a stressor for some of the children.     

Identifying Training Needs of Health-Care Providers Related to Treatment and Care of Transgendered Patients: A Qualitative Needs Assessment Conducted in New England

SUMMARY

The Transgender Training Project of the New England AIDS Education and Training Center has been providing training on transgender-related issues to health-care providers in the New England region since 1999, having trained nearly 600 providers in that time. The Transgender Training Project embarked on a study during the 2001–2002 grant year to interview providers of HIV-related care and advocacy on their knowledge and experience with working with trans-gendered people and to assess training needs to increase their effectiveness with transgendered clients.

The methodology consisted of face-to-face interviews with 13 providers of HIV treatment and care who are affiliated with the New England AIDS Education and Training Center network to discuss clinical challenges in working with transgendered people.

In this exploratory study, we found that providers had:

1. Desire to treat transgendered patients respectfully but admitted discomfort and lack of tools for specific interviewing/assessments.

2. Experience with a range of transgendered patients, but lack of information on distinctions among transgendered experiences.

3. Restrictions based on time constraints that create an overarching barrier in building trusting relationships with clients, and trusting relationships are integral to quality care.

4. Concern and frustration with lack of information, studies and research.

5. Concern and frustration with lack of treatment guidelines, (or ability to access them), referral contacts and ways to advocate for transgender clients.

6. Belief that training by transgendered people themselves was an essential teaching element.

These results point to the need for the development and dissemination of specific training materials and resources for health-care providers serving transgendered people living with or at risk for HIV.     

Replication of the factor structure of the fear of AIDS schedule (FAIDSS) across samples

Abstract

The stability of the Fear of AIDS Scale (FAIDSS) was studied using three samples (two samples of health workers and one of social work students) on Cattel's s index. Using hyperplane cutoffs between 0.35 and 0.45, on the five factor solution of the FAIDSS, there were significant correlations between factors across samples and with few exceptions each factor correlated significantly with only one factor in its comparison samples. Concurrent validity was demonstrated by comparing scores on the Attitudes toward AIDS scale with the FAIDSS. Data indicated that the FAIDSS structure was stable across samples and is an appropriate instrument for measurement of fear of AIDS in the helping professions.     

Changes in health status after one year for persons at-risk for and with HIV infection

Abstract

Health status is an important component of the evaluation of patient outcome in HIV infection where disease is chronic, progressive, and debilitating. This paper compares patient self-report for 9 dimensions of health status for patients followed in ATHOS (AIDS Time-Oriented Health Outcome Study). We compared changes in functioning after 12 months for 1, 524 patients with varying HIV disease severity: 238 asymptomatic, 447 symptomatic, 441 AIDS, and 398 HIV-negative individuals who are at-risk for infection.

Declines in health status were observed for all HIV-infected persons, including also asymptomatic patients. Individuals with symptomatic disease or AIDS had significant declines (p < 0.001) in physical functioning, energy, global health, pain, and increased disease symptoms, but no significant declines in health distress, cognition, or mental health. Persons with AIDS had greater declines than those with symptomatic disease. All HIV-infected individuals reported significantly fewer hours at work and more disability days than HIV-negative patients from similar risk pools. The adverse impact that HIV infection has on the health status of HIV-positive asymptomatic individuals is striking; HIV-negative individuals are more similar to HIV-positive individuals than to the general population.     

Chronic Patients’ Autonomy in Iranian Hospitals: A Qualitative Study

The autonomy of chronic patients in Iranian hospitals is challenged by impaired functioning resulting from chronic illness, a negative image in society, and effects related to hospitalization. Comprehensive interviews and observations of 34 patients, nurses, and physicians were performed to assess the autonomy of chronic patients in Iran. Conceptualization, constant comparison, and the combination of data resulted in the identification of 5 main categories related to autonomy: welcoming paternalism, self-expression, self-proof, shared decision making, and self-determination. Authority scrambling was a central category describing chronic patients’ perceptions of their autonomy during hospitalization. These patients sought to maintain their independence despite serious threats to their autonomy.