老年人和他们的护理人员在进行重大非心脏手术后的恢复经历
Nelly Toledano1, Nicholas Legacy1, Duminda N Wijeysundera2,3
1Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
JAMA network open
|March 13, 2026
概括
经历虚弱的老年人经常在经历重大手术后面临功能恢复和护理需求的挑战. 改善手术前教育和出院规划对于优化他们的康复和护理人员支持至关重要.
科学领域:
- 老年医学 老年医学
- 外科手术的结果
- 医疗保健服务研究 医疗服务研究
背景情况:
- 患有虚弱的老年人越来越多地接受手术,但关于他们的术后康复和支持需求的数据有限.
- 了解老年手术患者及其护理人员的经验对于改善护理至关重要.
研究的目的:
- 在重大非心脏手术后的前六个月中,描述患有虚弱的老年人 (65岁以上) 和他们的护理人员的康复经历.
- 确定与功能恢复,护理和支持相关的关键挑战和需求.
主要方法:
- 这是一项混合方法,前性嵌套队列研究,涉及加拿大17家医院.
- 包括65岁以上的成年人,临床虚弱度评分≥4,接受重大非心脏手术.
- 利用功能状态调查,护理需求和半结构面试进行深入体验.
主要成果:
- 204名老年人和85名护理人员参与了调查;63名 (43名患者,20名护理人员) 被采访.
- 在术后发现了日常生活障碍的重要仪器和基本活动,在6个月内下降.
- 关键主题包括准备不足,独立性降低,心理健康影响和需要更好的医疗保健支持.
结论:
- 大型手术后脆弱的老年人的术后功能恢复与患者和护理人员的日常生活障碍有关.
- 建议采取诸如增强手术前教育,护理人员参与出院计划和早期随访等干预措施,以优化康复.
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