„Sich zuhause sicher fühlen“ beginnt im Spital
Eine qualitative Studie zum Erleben von Patient_innen einer APN Hämatologie
Abstract
Zusammenfassung.Hintergrund: Hochdosierte Chemotherapien (HDC) und hämatopoetische Stammzelltransplantation (HSZT) sind komplexe Verfahren, die für Betroffene belastend sind. Zur Vorbereitung auf die Zeit zuhause benötigen sie bereits während des Spitalaufenthalts individuelle Begleitung und Edukation. Ziel: Es wurde untersucht, wie Patient_innen nach HDC mit oder ohne HSZT die Vorbereitungen auf die Zeit nach der Hospitalisation durch eine Advanced Practice Nurse (APN) Hämatologie erlebten und wie sie die Gestaltung ihres Alltags nach der Spitalentlassung erfuhren. Methode: Es wurden der qualitative Forschungsansatz "Interpretive Description" verwendet und elf Einzelinterviews mit sechs Teilnehmenden geführt. Die Texte wurden mehrmals gelesen, codiert, miteinander verglichen und ähnliche Inhalte mit den gleichen Codes bezeichnet. Ergebnisse: Patient_innen befinden sich in einem Prozess, "sich zunehmend sicherer fühlen". Dieser wird durch die Vorbereitung der APN unterstützt. Das zeigt sich während des Spitalaufenthalts an drei Themen: die Vertrauensbeziehung zur APN, der Gesamtüberblick der APN und die Stärkung des Gefühls von Sicherheit durch die APN. Zuhause setzt sich der Prozess "sich zunehmend sicherer fühlen" fort. Die Themen waren: zuhause ankommen, Wiederaufnehmen von Alltagsaktivitäten und Umsetzen der von der APN vermittelten Informationen. Schlussfolgerungen: Die Vorbereitung der APN unterstützt Patient_innen, ihren Alltag zuhause an ihre Situation angepasst zu gestalten. Dies weist darauf hin, dass die Vorbereitung der APN den Übergang vom Spital nach Hause erleichtert.
Abstract.Background: High dose chemotherapy (HDC) and hematopoietic stem cell transplantation (HSCT) are complex procedures bringing about physical and mental stress for the persons affected. In preparation for the time after their stay in the hospital, patients need individual support and education already during their hospital stay. Aim: The study investigated how patients after HDC with or without HSCT experienced the preparations by a hematology Advanced Practice Nurse (APN) for the post hospitalization phase and how they experienced managing their day-to-day life back at home. Methods: The qualitative research approach “Interpretive Description” was applied by conducting and subsequently transcribing eleven individual interviews with six participants. The texts were read multiple times before being coded. They were continuously compared with each other and similar contents were assigned the same codes. Results: Patients find themselves in a “process of increasingly feeling secure”. This process is supported by the preparation of the APN. This is reflected in three themes during their hospitalization: the relationship of trust with the APN, the comprehensive overview of the APN and the APN strengthening the feeling of security. The experience of finding back to daily life at home shows that the process of “increasingly feeling secure” is ongoing. Themes within this phase were: arriving at home, resuming daily routines and implementing the information received from the APN. Conclusions: The companionship provided by the APN enables patients to appropriately cope with their day-to-day life at home. The findings suggest that the preparations of the APN facilitate the transition from the hospital to day-to-day life back home.
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