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Fræðsla skurðsjúklinga : inntak, ánægja og áhrifaþættir

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Authors
Katrín Blöndal
Heiða Steinunn Ólafsdóttir
Sesselja Jóhannesdóttir
Herdís Sveinsdóttir
Issue Date
2011-02

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Other Titles
Surgery related information : content, satisfaction and influential factors
Citation
Tímarit hjúkrunarfræðinga 2011, 87(1):49-60
Abstract
Rannsóknir hafa sýnt margháttaðan ávinning sjúklingafræðslu en lítið er vitað um gagnsemi fræðslu eða ánægju skurðsjúklinga á Íslandi með veitta fræðslu. Megintilgangur þessarar rannsóknar var að lýsa fræðslu sem skurðsjúklingar á Landspítala telja sig fá á sjúkrahúsi og heima fjórum vikum síðar og meta hvað hefur áhrif á ánægju þeirra með fræðsluna. Úrtakið var 733 innkallaðir sjúklingar sem fóru í valaðgerð 15. janúar til 15. júlí 2007. Svörun var 74%. Gagna var aflað með tveim spurningalistum, á sjúkrahúsinu og heima fjórum vikum eftir heimkomu. Spurt var um sjúklingafræðslu og ánægju með hana, kvíða og þunglyndi, verki og önnur einkenni, aðdraganda sjúkrahúsvistar og sjúkrahúsdvöl, heilsufar og árangur aðgerða, ánægju með umönnun og stuðning og bakgrunn þátttakenda. Almennt voru sjúklingar ánægðir með fræðsluna. Þeir voru þó ánægðari aðspurðir á spítalanum heldur en heima. Atriði, sem sjúklingar óskuðu frekari fræðslu um á sjúkrahúsinu, voru einkum fylgikvillar aðgerðar, hreyfing, sjúkdómur og verkir en eftir heimkomu ýmislegt sem tengist verkjum og afturbata. Minni ánægja með fræðslu fyrir aðgerð tengdist meiri sársauka á spítalanum, minni gagnsemi upplýsinga fyrir aðgerð, minni stuðningi vina og ættingja á spítala og minni ánægju með umönnun á spítalanum. Þættir, sem höfðu áhrif á minni ánægju með fræðslu á spítala um ferlið eftir að heim var komið, tengdust meðal annars kvíðaeinkennum á spítala og heima, þunglyndiseinkennum á spítala og heima, sársauka á spítala og almennt einkennum fyrir aðgerð og heima. Aðrir þættir, sem þessu tengdust, voru að vilja fá betri upplýsingar, hafa ekki náð sér eftir aðgerð, minni ánægja með stuðning vina og ættingja svo og minni ánægja með umönnun. Þá voru yngri sjúklingar og konur óánægðari. Fræðsluþarfir skurðsjúklinga eru umfangsmiklar og vara fram yfir sjúkrahúsvistina. Bæta þarf einstaka þætti fræðslunnar og skipuleggja sérstaklega mat, fræðslu og eftirfylgd sjúklinga sem fyrirsjáanlega vegnar ver. Ávinningur gæti orðið aukin ánægja sjúklinga og ódýrari heilbrigðisþjónusta vegna fækkunar einkenna, fylgikvilla og endurinnlagna.
Research has shown various benefits of patient education. However little is known about its effectiveness and about Icelandic surgical patients’ satisfaction with the education. This study aims to describe the perceived information surgical patients at Landspítali – University hospital receive at the hospital and at home four weeks later and assess what affects their satisfaction with received information. The sample included 733 patients admitted for planned surgery from January 15th to July 15th 2007. The response rate was 74%. Information was collected with two questionnaires, administered at the hospital and at home four weeks later, addressing symptoms, patient information, support, satisfaction, disease, surgery, situation at home, and background. Generally the patients were satisfied with the information received. At the hospital the patients most often wanted more information about complications of surgery, movement, disease, and pain. At home they wanted more information about pain and the period of recovery. Less satisfaction with information was related to more pain at the hospital, less beneficial information before surgery, less support of friends and family at the hospital and less satisfaction with the care they received at the hospital. Less satisfaction with information they received at the hospital about post-discharge recovery was for example related to anxiety at the hospital and at home, depression at the hospital and home and pain at the hospital. Less satisfaction with information they received at the hospital was also related to symptoms in general before surgery and at home, wanting better information, not having recovered after surgery and less satisfaction with the support of friends and family. Women and younger patients were more dissatisfied. Surgical patients have extensive educational needs. Special consideration must be given to the information and follow-up of patients at risk for negative outcome and those who are dissatisfied with care. The benefits could be more satisfied patients and less health care related expenses because of fewer symptoms, complications and readmissions to hospital.
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