Reported roles of care partners in a specialized weaning centre-perspectives of patients, care partners, and health care providers.

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES Frontiers in health services Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI:10.3389/frhs.2024.1439410
L Istanboulian, A Gilding, L Hamilton, T Master, S Bingler, M Hill, S Isani, S Kazi, S Coppinger, K Smith
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Abstract

Background: Care partners are individuals chosen by a person with an illness to support their care during hospitalization. Patients with persistent critical illness have longer than average critical care admission and often other conditions including dysphagia, communication vulnerability, severe physical deconditioning, the need for an artificial airway, and difficulty weaning from invasive mechanical ventilation. Family presence has been identified as important for patients experiencing persistent critical illness in specialized weaning centers. Despite this, the role of care partners in clinical settings for patients with persistent critical illness has not been fully characterized, particularly from the perspectives of patients, care partners, and health care providers. The aim of this study was to gain insights into the roles of care partners during persistent critical illness from the perspectives of patients, care partners, and health care providers.

Methods: We used qualitative descriptive methodology including semi-structured interviews and content analysis. Interviews were audio recorded and transcribed verbatim. Included participants (n = 30) were patient survivors (n = 7), care partners of patient survivors (n = 9), and professionally diverse health care providers (n = 14) of adult patients with persistent critical illness from two specialized units in one community academic hospital in Toronto, Canada.

Results: Participants across all groups described care partner roles that included physical, mental health, cognitive, social, and spiritual support of the patient, including the perceived role of safeguarding the multiple dimensions of care for the patient who is experiencing persistent critical care in specialized care settings.

Discussion: The results of this study are being used to co-design, implement, and evaluate a sustainable care partner program that is acceptable, appropriate, and feasible to implement in clinical settings where the care of patients with persistent critical illness occurs.

Reporting method: Consolidated criteria for reporting qualitative studies (COREQ).

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专业断奶中心护理伙伴的角色报告--患者、护理伙伴和医疗服务提供者的观点。
背景:护理伙伴是指由患者选择在住院期间为其提供护理支持的个人。顽固性危重症患者的入院时间比一般危重症患者要长,通常还伴有其他病症,包括吞咽困难、交流障碍、身体严重衰弱、需要人工气道以及难以从有创机械通气中断奶。在专门的断奶中心,家人的陪伴对经历持续危重病的患者非常重要。尽管如此,护理伙伴在顽固性危重症患者的临床环境中所扮演的角色还没有被充分描述,特别是从患者、护理伙伴和医疗服务提供者的角度来看。本研究旨在从患者、护理伙伴和医疗服务提供者的角度深入了解护理伙伴在危重症持续期间的角色:我们采用了定性描述方法,包括半结构式访谈和内容分析。我们对访谈进行了录音和逐字记录。参与者(n = 30)包括患者幸存者(n = 7)、患者幸存者的护理伙伴(n = 9)以及来自加拿大多伦多一家社区学术医院两个专科病房的不同专业的成年重症患者医疗服务提供者(n = 14):结果:所有小组的参与者都描述了护理伙伴的角色,包括为患者提供身体、心理健康、认知、社会和精神支持,其中包括为在专科护理环境中经历持续危重症的患者提供多方面护理的感知角色:本研究的结果将用于共同设计、实施和评估一项可持续护理伙伴计划,该计划可在护理持续危重症患者的临床环境中实施,具有可接受性、适宜性和可行性:报告方法:定性研究综合报告标准(COREQ)。
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