老年髋部骨折术后患者跌倒恐惧心理体验的质性研究

doi:10.3761/j.issn.0254-1769.2021.04.008

摘要/Abstract

摘要：

目的了解老年髋部骨折术后患者跌倒恐惧的心理体验。方法采用描述性质性研究方法,以最大差异抽样法选取2019年12月—2020年5月河南省某三级甲等骨科医院老年髋部骨折术后患者12例进行半结构式访谈,使用内容分析法整理分析访谈资料。结果老年髋部骨折术后患者跌倒恐惧的体验可归纳为3个主题：对跌倒恐惧的感知（被打乱的生活、负性情绪的困扰、对未来的担忧、内在的力量）;对跌倒恐惧的态度和行为（小心谨慎的态度、回避行为、冒险行为）;居家康复护理的需求（跌倒和再骨折预防的知识需求、生活照顾的需求、居家康复的需求、家庭与社会支持的需求、延续照护服务的需求）。结论针对老年髋部骨折术后患者普遍存在的跌倒恐惧和个体化体验,护理人员应增加对患者跌倒恐惧的理解,重视其内心体验和居家康复护理的需求。同时,积极发展延续性照护以减少患者跌倒恐惧,促进术后康复和心理社会适应,降低跌倒和再骨折风险。

关键词: 髋部骨折, 功能康复, 老年人, 跌倒恐惧, 体验, 描述性质性研究, 护理

Abstract:

Objective This qualitative study aimed to explore the experiences of fear of falling in elderly patients following hip fracture surgery. Methods From December 2019 to May 2020,12 patients following hip fracture during postoperative rehabilitation period were recruited from a tertiary hospital in Henan province by maximum variation sampling. Semi-structured interviews were performed to collect data and qualitative content analysis was conducted to analyze the data. Results 3 themes regarding fear of falling were extracted,including perception of falling fear（disrupted life,negative emotions,a feeling of worrying about the future,inner strength）;attitude and behavior towards fear of falling（cautious attitude,avoidance behavior,risky behavior with falling risk）;the needs for home-based rehabilitation and nursing（the need for knowledge of prevention of falls and secondary fractures,the needs for life care,the needs for home-based rehabilitation,the needs for family and social support,and the needs for continuous care services）. Conclusion The fear of falling was universal and multifaceted. Nurses should increase their understanding of falling fear,pay attention to their inner experience and home rehabilitation nursing needs. Continuous care services should be developed to reduce patients’ fear of falling,to promote postoperative rehabilitation and psychosocial adaptation,and to reduce the risk of falling and refracture.

Key words: Hip Fracture, Functional Rehabilitation, Aged, Fear of Falling, Experience, Descriptive Qualitative Research, Nursing Care

张华果,司文腾,何宇迪,宋咪,皮红英. 老年髋部骨折术后患者跌倒恐惧心理体验的质性研究[J]. 中华护理杂志, 2021, 56(4): 527-533.

ZHANG Huaguo,SI Wenteng,HE Yudi,SONG Mi,PI Hongying. Experiences of fear of falling in elderly patients following hip fracture surgery：a qualitative descriptive study[J]. Chinese Journal of Nursing, 2021, 56(4): 527-533.

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