上肢严重创伤保肢患者康复早期症状报告结局的混合方法研究
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女,硕士,副主任护师

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中华护理学会青年项目(ZHKYQ202317);无锡市卫生健康委科技成果与适宜技术推广项目(T202204)


A mixed-methods study on the outcomes of symptom reporting in the early rehabilitation period in patients with severe upper limb trauma undergoing limb salvage
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    摘要:

    目的 探讨上肢严重创伤保肢患者康复早期症状的多样性及照护需求,为制订延续性干预措施提供依据。方法 采用平行设计的混合方法研究,以互补视角全面分析患者症状及需求。应用便利抽样法,对216例上肢严重创伤保肢患者采用中文版患者报告结局测量信息系统29项量表2.1版进行问卷调查;同时采用目的性抽样,对14例严重上肢创伤保肢患者进行半结构式访谈。结果 216例严重肢体创伤患者报告结局症状严重程度排名前3位的分别是身体功能、焦虑症状、疼痛影响。质性研究提炼出生理症状的动态演变与阶段性特征、心理负荷的持续存在与支持缺位、社交功能受限与自我认同危机、康复依从性障碍与资源可及性差异4个主题,与量性结果形成多维互补。结论 上肢严重创伤患者术后康复早期症状多样化且管理需求强烈,可通过制订症状管理方案和建设信息化平台为患者提供支持。

    Abstract:

    Objective To explore the diversity of symptoms and care needs in the early rehabilitation period of patients with severe upper limb trauma who have undergone limb salvage, and to provide a basis for the development of continuous intervention mea-sures.Methods A parallel mixed-methods research design was used to comprehensively analyze patients′ symptoms and needs from complementary perspectives.A convenience sampling method was adopted to survey 216 patients with severe upper limb trauma who had undergone limb salvage using the Chinese version of Patient Reported Outcomes Measurement Information System 29-item Profile version 2.1(PROMIS-29v2.1).Simultaneously, 14 patients with severe upper limb trauma who had undergone limb salvage were selected for semi-structured interviews using purposive sampling.Results Among the 216 patients with severe limb trauma, the top three most severe symptoms reported were physical function, anxiety symptoms, and pain impact.The qualitative study identified four themes:the dynamic evolution and stage characteristics of physiological symptoms, the persistent psychological burden and lack of support, restricted social function and identity crisis, and rehabilitation adherence barriers and differences in resource accessibility.These themes complemented the quantitative results from multiple dimensions.Conclusion Patients with severe upper limb trauma exhibit diverse symptoms and strong management needs in the early postoperative rehabilitation period.It is suggested that symptom management plans and the information platforms can be developed to provide support for patients.

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莫兰,傅育红,苏晓雯,姚玉,周文,崔月景,陈思亦,李佳慧.上肢严重创伤保肢患者康复早期症状报告结局的混合方法研究[J].护理学杂志,2025,(13):1-6+11

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  • 收稿日期:2025-02-04
  • 最后修改日期:2025-02-04
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  • 在线发布日期: 2025-07-31