儿童通气管手术后的术后护理:挪威家长的长期经验定性研究。

IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY American Journal of Otolaryngology Pub Date : 2024-08-03 DOI:10.1016/j.amjoto.2024.104457
Bjarne Austad , Ann Helen Nilsen , Wenche Moe Thorstensen , Anne-Sofie Helvik
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引用次数: 0

摘要

目的在由耳鼻喉科医生或普通全科医生(GP)进行检查的情况下,探讨父母在通气管(VT)手术后头两年的术后护理经验:1.家长对医疗系统的信任和预约检查的责任。几乎所有的家长似乎都对医疗系统保持信任,并认为无论在哪里做检查都能得到保障。尽管如此,如果可以从货架上选择的话,他们还是更愿意选择由耳鼻喉科医生主导的医疗服务。在需要时,他们会承担起寻求医疗保健的责任,并体验到全科医生会在必要时转介他们的孩子。2.2. 随着时间的推移,家长的担忧会减少。大多数家长认为他们的孩子在手术后保持了健康,他们对术后检查的需求也减少了。对于面临持续问题的患儿,大多数家长都认为他们的孩子所面临的挑战得到了专业的处理,他们也就不再那么担心了。一些家长将孩子的行为或语言障碍归因于其他诊断,从而加深了对孩子病情的理解。3.渴望了结。家长希望对孩子的康复得到保证,并希望通过专业评估来了结孩子的病情。有些家长主张进行测听,有些家长则相信自己对孩子听力的评估。转学是一个关键时刻,引发了对社会融入的担忧:总的来说,无论术后护理是由耳鼻喉科医生还是全科医生提供,家长们都认为他们的孩子得到了保障。尽管如此,许多家长还是倾向于由耳鼻喉科医生进行检查。随着术后时间的推移,家长对 VT 的担忧和关注有所减少,但即便如此,许多家长仍希望能有一个 "结案",以确保听力达到最佳状态,并拒绝接受 VT。我们主张采用个性化的术后护理方法,以满足特定的医疗需求,而不强加不必要的检查。
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Postoperative care for children after ventilation tube surgery: A qualitative study of parents' experiences over time in Norway

Objective

To explore the parents' experience of postoperative care during the first two years after ventilation tube (VT) surgery in a setting where the check-ups were conducted either by otolaryngologists or their regular general practitioner (GP).

Methods

55 individual interviews of parents at up to three different time points (<1, 6, and 24 months) after their child received VT-surgery, analyzed with reflexive thematic analysis.

Results

1. Parents' trust in the healthcare system and responsibility for booking check-ups. Nearly all parents seemed to maintain trust in the healthcare system and felt safeguarded regardless of where they had their check-ups. Still, they would prefer otolaryngologist-led care if they could choose from the top shelf. They took responsibility for seeking healthcare when needed and experienced that their GP referred their child if necessary. 2. As time goes by, parental worries are reduced. Most experienced that their child stayed healthy after surgery, and their demand for postoperative check-ups decreased. For the children who faced ongoing issues, most parents experienced that their child's challenges had been handled professionally, and they became less worried. Some parents attribute other diagnoses to their child's behavior or speech delays, refining their understanding of their child's condition. 3. The desire for closure. Parents sought reassurance about their child's recovery and desired professional evaluation for closure. While some advocated for audiometry, others trusted their own assessments about hearing. The transition to school marked a pivotal time, prompting concerns about social inclusion.

Conclusion

Overall, the parents experienced that their child was safeguarded irrespective of whether postoperative care was provided by otolaryngologists or GPs. Still, many preferred check-ups by an otolaryngologist. The parental worries and focus on the VTs were reduced as time went by after surgery, but even so many wanted a ‘closure’ to be sure that the hearing was as good as it could be and the VTs rejected. We advocate for an individualized approach to postoperative care that addresses specific medical needs without imposing unnecessary check-ups.

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来源期刊
American Journal of Otolaryngology
American Journal of Otolaryngology 医学-耳鼻喉科学
CiteScore
4.40
自引率
4.00%
发文量
378
审稿时长
41 days
期刊介绍: Be fully informed about developments in otology, neurotology, audiology, rhinology, allergy, laryngology, speech science, bronchoesophagology, facial plastic surgery, and head and neck surgery. Featured sections include original contributions, grand rounds, current reviews, case reports and socioeconomics.
期刊最新文献
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