了解患者对围手术期过敏反应的认知、知识和经验:一项定性访谈研究。

IF 9.2 1区 医学 Q1 ANESTHESIOLOGY
Louise Savic, Anoop Mistry, Sinisa Savic, Gururaj Arumugakani, Rupert Pearse, Lene Heise Garvey, Philp M Hopkins, Nikki Rousseau
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引用次数: 0

摘要

背景:危及生命的过敏反应可发生在手术和麻醉。患者对这些事件的感知、知识和经验在很大程度上未被报道。更好地了解患者的观点可能会影响未来治疗途径的设计。方法:邀请到约克郡围手术期过敏临床调查的成年患者(≥18岁)在就诊前1周和就诊后1周进行半结构化访谈。招募患者直到主题饱和。代码本的主题分析是在一个连续的、迭代的过程中进行的。结果:共纳入11例患者(22次访谈)。我们确定了四个关键主题:(1)反应过程中“缺席”(无意识)的影响;(2)过敏反应对患者的影响;(3)了解过敏及过敏试验;(4)对未来手术过程中脆弱性的感知。对许多人来说,“缺席”让他们更难处理这一事件;对其他人来说,这是一种保护。许多人产生了影响日常生活的深刻脆弱感。其他健康问题与该事件相互作用并改变了其影响。对过敏的理解普遍较差;有几个病人对他们的诊断有不准确的回忆。尽管对未来的手术感到焦虑,但患者往往对是否需要告诉医疗保健专业人员他们的诊断表现出矛盾,认为“系统”会代表他们行事。结论:围手术期过敏事件可引起持续性焦虑,显著影响患者的生活质量。对过敏诊断及其含义的误解使患者在未来的手术中面临巨大的风险。有必要提高患者的意识,以减少这种风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Understanding patient perceptions, knowledge, and experience of perioperative allergic reactions: a qualitative interview study.

Background: Life-threatening allergic reactions can occur during surgery and anaesthesia. Patients' perceptions, knowledge, and experience of these events are largely unreported. Better understanding of patient perspectives might influence the design of future treatment pathways.

Methods: Adult patients (≥18 yr) referred to the Yorkshire Perioperative Allergy Clinic for investigation were invited to semi-structured interviews 1 week before and 1 week after their clinic visit. Patients were recruited until thematic saturation was achieved. Codebook thematic analysis of transcripts was conducted in a continuous, iterative process.

Results: We recruited 11 patients (22 interviews). We identified four key themes: (1) impact of being 'absent' (unconscious) during the reaction; (2) implications of the allergic reaction for the patient; (3) understanding of allergy and allergy testing; (4) perception of vulnerability during future surgery. For many, being 'absent' made it harder to process the event; for others this was protective. Many developed a profound sense of vulnerability affecting daily life. Other health concerns interacted with and modified the impact of the event. Understanding of allergy was generally poor; several patients had inaccurate recall of their diagnosis. Despite anxiety about future surgery, patients often appeared ambivalent about the need to tell healthcare professionals about their diagnosis, believing 'the system' would act on their behalf.

Conclusions: Perioperative allergic events cause persistent anxiety, significantly impacting quality of life. Misunderstanding around the allergy diagnosis and its implications exposes patients to substantial risk during future surgery. There is a need for greater patient awareness to reduce this risk.

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来源期刊
CiteScore
13.50
自引率
7.10%
发文量
488
审稿时长
27 days
期刊介绍: The British Journal of Anaesthesia (BJA) is a prestigious publication that covers a wide range of topics in anaesthesia, critical care medicine, pain medicine, and perioperative medicine. It aims to disseminate high-impact original research, spanning fundamental, translational, and clinical sciences, as well as clinical practice, technology, education, and training. Additionally, the journal features review articles, notable case reports, correspondence, and special articles that appeal to a broader audience. The BJA is proudly associated with The Royal College of Anaesthetists, The College of Anaesthesiologists of Ireland, and The Hong Kong College of Anaesthesiologists. This partnership provides members of these esteemed institutions with access to not only the BJA but also its sister publication, BJA Education. It is essential to note that both journals maintain their editorial independence. Overall, the BJA offers a diverse and comprehensive platform for anaesthetists, critical care physicians, pain specialists, and perioperative medicine practitioners to contribute and stay updated with the latest advancements in their respective fields.
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