获得性脑损伤患者家庭支持性干预的临床背景分析:一项定性研究

Véronique de Goumoëns, C. Grandjean, D. Joye, Yann-Olivier Bettex, P. Ryvlin, A. Ramelet
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引用次数: 1

摘要

获得性脑损伤(ABI)是成人致残的主要原因之一。支持ABI患者的家属是良好实践的一部分,但这在瑞士并不是系统化的。在实施新的干预措施之前,对环境因素进行了分析。目的:本研究的目的是描述跨学科管理团队对这些家庭支持的观点,并探讨干预的背景资源和障碍。方法:对某三级参考医院临床神经科进行描述性定性研究。根据基于卡尔加里家庭评估和干预模型的访谈指南,对8名护理经理进行了半结构化访谈。采用归纳和演绎含量分析法对数据进行分析。结果:通过分析得出了相关系统的4个主要类别(家庭系统、护理系统、环境和协作)和15个小类别。专业间协作和工作环境的特点是参与者关注的两个关键方面。讨论和结论:参与者认为目前的护理没有充分考虑家庭,也没有充分整合家庭。建议从具体的角度进行改进,例如从住院急性期开始系统和有组织地整合家庭,以及发展跨专业合作,以支持ABI患者的家庭。摘要简介:获得性脑损伤(ABI)是成人致残的主要原因之一。支持ABI患者的家属是良好实践的一部分,但这在瑞士并不是系统化的。在实施新的干预措施之前,对环境因素进行了分析。目的:本研究的目的是描述跨学科管理团队对这些家庭支持的观点,并探讨干预的背景资源和障碍。方法:对某三级参考医院临床神经科进行描述性定性研究。根据基于卡尔加里家庭评估和干预模型的访谈指南,对8名护理经理进行了半结构化访谈。采用归纳和演绎含量分析法对数据进行分析。结果:通过分析得出了相关系统的4个主要类别(家庭系统、护理系统、环境和协作)和15个小类别。专业间协作和工作环境的特点是参与者关注的两个关键方面。讨论和结论:参与者认为目前的护理没有充分考虑家庭,也没有充分整合家庭。建议从具体的角度进行改进,例如从住院急性期开始系统和有组织地整合家庭,以及发展跨专业合作,以支持ABI患者的家庭。
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Analyse du contexte clinique dans le développement et l’implantation d’une intervention de soutien pour les familles de patients atteints de lésions cérébrales acquises : une étude qualitative
Introduction: Acquired brain injuries (ABI) are among the leading causes of disability in adults. Supporting the families of patients with ABI is part of good practice, but this is not systematic in Switzerland. Preceding the implementation of a new intervention, an analysis of the contextual factors was carried out. Objectives: The objectives of this study were to describe the perspectives of interdisciplinary management teams concerning the support of these families and to explore the contextual resources and obstacles of the intervention. Methods: A descriptive qualitative research was conducted in a clinical neurosciences department of a tertiary reference hospital. Semi-structured interviews were conducted with a targeted sample of 8 care managers, following an interview guide based on the Calgary Models of Family Assessment and Intervention. Data were analyzed using the inductive and deductive content analysis method. Results: Four main categories of interrelated systems (family system, care system, environment and collaboration) and 15 subcategories emerged from the analysis. Interprofessional collaboration and characteristics of the work environment were two key aspects for participants. Discussion and conclusion: Participants felt that current care does not adequately consider families nor integrate them sufficiently. Concrete perspectives for improvement such as the systematic and structured integration of families from the acute phase of hospitalization, as well as the development of interprofessional collaboration are recommended to support families of individuals with ABI. Abstract Introduction : Acquired brain injuries (ABI) are among the leading causes of disability in adults. Supporting the families of patients with ABI is part of good practice, but this is not systematic in Switzerland. Preceding the implementation of a new intervention, an analysis of the contextual factors was carried out. Objectives : The objectives of this study were to describe the perspectives of interdisciplinary management teams concerning the support of these families and to explore the contextual resources and obstacles of the intervention. Methods : A descriptive qualitative research was conducted in a clinical neurosciences department of a tertiary reference hospital. Semi-structured interviews were conducted with a targeted sample of 8 care managers, following an interview guide based on the Calgary Models of Family Assessment and Intervention. Data were analyzed using the inductive and deductive content analysis method. Results : Four main categories of interrelated systems (family system, care system, environment and collaboration) and 15 subcategories emerged from the analysis. Interprofessional collaboration and characteristics of the work environment were two key aspects for participants. Discussion and conclusion : Participants felt that current care does not adequately consider families nor integrate them sufficiently. Concrete perspectives for improvement such as the systematic and structured integration of families from the acute phase of hospitalization, as well as the development of interprofessional collaboration are recommended to support families of individuals with ABI.
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