Compartmentalising time and space: a phenomenological interpretation of the temporal experience of commencing haemodialysis
Compartmentalising time and space: a phenomenological interpretation of the temporal experience of commencing haemodialysis
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DOI：
10.1111/jocn.13697
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发表时间：
2017-11-01
影响因子：
4.2
通讯作者：
Stewart, Glenn
中科院分区：
文献类型：
--
作者：
Gullick, Janice;Monaro, Susan;Stewart, Glenn
目的和目的。解读终末期肾病患者及其家人在血液透析前几个月的时空体验。虽然透析是终末期肾脏疾病治疗的支柱，但实际开始治疗往往是人们和家庭意想不到的。不良的生物心理社会准备意味着血液透析的开始被视为一种危机。虽然先前的现象学研究表明，随着时间的推移，将透析习惯性地纳入一个人的自我概念是可能的，但对血液透析新手的时空体验还没有很好的理解。¶；¶；设计。现象学研究方法。经过有目的的抽样，18名参与者在澳大利亚悉尼的住院期间或在公立医院的血液透析单元接受治疗时被招募。11名在过去3个月内开始血液透析的人和5名近亲分别接受了半结构式访谈。在海德格尔框架内的解释学解释是通过对早期血液透析经验及其与存在的关系的前后分析进行的。与作为新的血液透析患者或照顾者的世界存在的时间和空间理解相关的主题包括：“将生活划分为透析和非透析的日子”(失去的时间、时钟时间和活着的时间)--“划分过去、现在和未来”(正常化“以前”、处理“现在”和“未来”)；最后，“划分空间”。在透析开始后的几个月里，患者和家庭护理人员将时间和空间分割开来，失去了有意义的、活着的时间的连续性，这些时间曾经框定了人们过去对正常的感觉。资源增加活动应侧重于社会联系和提供人员和/或基础设施，以减少无聊，促进参与有意义的任务，并酌情支持在透析期间继续开展工作活动。
Aims and objectives. To interpret the spatio-temporal experience of people with end-stage kidney disease and their families in the first months of haemodialysis.& para;& para;Background. While dialysis is the mainstay of end-stage kidney disease management, the actual initiation of treatment is often unexpected by people and families. Poor biopsychosocial preparation means haemodialysis commencement is experienced as a crisis. While previous phenomenological studies suggest that over time, a habitual incorporation of dialysis into one's self-concept is possible, the spatio-temporal experience of people new to haemodialysis is not well understood. & para;& para;Design. A phenomenological study.& para;& para;Methods. Following purposive sampling, 18 participants were recruited either during an inpatient admission or while attending a public hospital-based haemodialysis unit in Sydney, Australia. Eleven people who had commenced haemodialysis within the previous three months and five close family members were separately engaged in semistructured interviews. Hermeneutic interpretation within a Heideggerian framework occurred through a backward-and-forward analysis between the early haemodialysis experience and its relationship to Being.& para;& para;Results. Themes that related to a temporal and spatial understanding of Being-in- the-world as a new haemodialysis patient or carer included the following: 'compartmentalising life into dialysis and non-dialysis days' (lost time, clock time and lived time)-, 'compartmentalising before, now and future' (normalising the 'before', dealing with the 'now' and the 'foreverness' of dialysis ); and finally, 'compartmentalising space'.& para;& para;Conclusions. In the months after dialysis commencement, patients and family carers compartmentalise time and space with a loss of continuity of meaningful, lived time that had framed people's past sense of normal.& para;& para;Relevance to clinical practice. Resource enhancement activities should focus on social connectivity and provision of personnel and/or infrastructure to reduce boredom, to facilitate engagement with meaningful tasks and, where appropriate, to support the continuation of work activities during the dialysis period.