Perceptions of patients with wounds due to chronic limb-threatening ischemia.
Perceptions of patients with wounds due to chronic limb-threatening ischemia.
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DOI：
10.1177/1358863x20987896
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发表时间：
2021-04
期刊：
影响因子：
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通讯作者：
Humphries MD
中科院分区：
文献类型：
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作者：
Ceja Rodriguez M;Mark JR;Gosdin M;Humphries MD
慢性肢体威胁性缺血（CLTI）患者在下肢伤口护理方面面临许多障碍。我们探讨了CLTI患者的看法，他们的伤口/管理，并试图确定他们的血管供应商的态度，以及通过远程医疗管理的意愿。要求住院接受Rutherford 5级和6级CLTI治疗的患者完成伤口评价调查，并参加半结构化访谈。半结构化访谈记录，转录，并使用归纳编码策略进行分析。对代码进行了分组，以便进行专题分析，并将其汇总为断言。采访了11名平均年龄为60岁（35-79岁）的患者。所有患者均患有外周动脉疾病（PAD），8例患者同时患有糖尿病。确定了三个首要主题。首先，病人似乎有有限的应对机制，并被他们的伤口护理不堪重负。其次，在这一队列的患者中，许多人已经成为他们护理的被动观察者，这表现为对他们的疾病过程的有限理解和对伤口管理的脱离。第三个主题是尽一切努力防止肢体丧失的愿望有多强烈，但患者承认，在资源有限的情况下，这很难转化为真实的生活。CLTI患者有血管提供者必须认识到并解决的问题，以建立牢固的患者-提供者关系，并增加激活以管理他们的伤口和其他医疗状况。能够获得技术和指导的患者可能能够理解通过远程医疗获得护理。
Patients with chronic limb-threatening ischemia (CLTI) face numerous barriers to caring for lower extremity wounds. We explored the perceptions of CLTI patients to their wound/management and sought to determine attitudes towards their vascular provider as well as willingness for management through telemedicine. Patients admitted to hospital for treatment of Rutherford Grade 5 and 6 CLTI were asked complete a wound evaluation survey and took part in a semi-structured interview. Semi-structured interviews were recorded, transcribed, and analyzed using an inductive coding strategy. Codes were grouped for thematic analysis and aggregated into assertions. Eleven patients with a mean age of 60 years (35–79 years) were interviewed. All patients had peripheral artery disease (PAD) and eight patients had diabetes as well. Three overarching themes were identified. First, patients appear to have limited coping mechanisms and are overwhelmed by the care of their wounds. Second, in this cohort of patients, many had become passive observers of their care as demonstrated by a limited understanding of their disease processes and detachment from wound management. The third theme was how strong the desire to do everything to prevent limb loss was, but patients acknowledged this is hard to translate into real life with limited resources. Patients with CLTI have concerns that vascular providers must recognize and address to build strong patient–provider relationships and increase activation for management of their wounds and other medical conditions. Patients who have access to technology and with guidance may be able to understand getting care through remote medicine.