[关键词]
[摘要]
目的 探讨医护人员实施冠状动脉旁路移植术(coronary artery bypass grafting,CABG)后Ⅰ期心脏康复的障碍感知,为后续针对性干预提供依据。方法 采用描述性质性研究方法,基于理论域框架设置访谈提纲,以目的抽样法选取15名医护人员进行半结构访谈,采用框架内容分析法对访谈资料进行整理和分析。结果 结合理论域框架,分析得出医护人员实施CABG术后Ⅰ期心脏康复的障碍感知主题:知识缺乏、技能缺乏、职业界限模糊、专业自信不足、预期评价不佳及患者配合程度不足、目标不坚定、认知负荷、资源匮乏及环境互动不佳、组织氛围及社会支持缺乏、消极影响、实施流程及监管措施缺失和习惯改变困难。结论 医护人员实施CABG术后Ⅰ期心脏康复的障碍因素具有多样性,本研究归纳的目标领域的主题内容可为心脏康复管理策略和临床实践方案的制定和改进提供参考。
[Key word]
[Abstract]
Objective To explore the perceived barriers in the implementation of phase Ⅰ cardiac rehabilitation after coronary artery bypass grafting (CABG) in health professionals,and to provide references for targeted intervention.Methods The study was carried out with descriptive qualitative methodology through semi-structured interviews based on the theoretical domain framework (TDF),after interviewing 15 selected medical staff,and the data were collected and analyzed through content analysis.Results Findings showed that with TDF,perceived themes of barriers for healthcare professionals to implement phase I cardiac rehabilitation after CABG included the lack of knowledge,lack of skills,blurring of professional boundaries,lack of professional self-confidence,poor evaluation of expectations and inadequate patient cooperation,lack of commitment to the goal,cognitive load,lack of resources and poor environmental interaction,lack of organizational climate and social support,negative influences,lack of implementation processes and monitoring measures and difficulty in changing habits.Conclusions There are multiple factors affecting health professionals’ implementation of phase Ⅰ cardiac rehabilitation after CABG,which can provide reference for the development and improvement of cardiac rehabilitation management strategies and clinical practice protocols.
[中图分类号]
R473.6
[基金项目]
上海市浦东新区卫生系统重要薄弱学科建设项目资助(PWZbr2022-04);同济大学医学院学科建设三年行动计划重点学科项目(JS2210103);浦东新区卫生系统领先人才培养计划(PWRl 2020-10)