脑卒中患者疾病体验及其复发风险感知的质性研究  

A qualitative study on disease experience and recurrence risk perception of stroke survivors

作　　者：林蓓蕾[1] 郭云飞 张振香[1] 梅永霞[1] 宋俊莉[2] 薛利红[3] 彭睿 翟清华[5] LIN Beilei;GUO Yunfei;ZHANG Zhenxiang;MEI Yongxia;SONG Junli;XUE Lihong;PENG Rui;ZHAI Qinghua

机构地区：[1]郑州大学护理与健康学院,郑州市450001 [2]郑州大学第五附属医院神经内科 [3]滑县人民医院护理部 [4]郑州市中心医院神经内科 [5]郑州大学第二附属医院护理部

出　　处：《中华护理杂志》2021年第1期80-85,共6页Chinese Journal of Nursing

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ2018052);河南省科技厅重点科技攻关项目(192102310098)。

摘　　要：目的了解首发与复发脑卒中患者的疾病体验,探讨脑卒中患者复发风险感知的特征及变化。方法采用现象学研究方法,对19例脑卒中患者进行半结构式深入访谈,运用Colaizzi 7步分析法对访谈资料进行分析。结果首发、首次复发和多次复发脑卒中患者的疾病体验和复发风险感知各有特征。首发脑卒中患者:可识别异常但缺乏专业信息渠道,主动就诊意识强并感知及时就诊益处大,预后态度过于乐观易忽略复发风险;首次复发脑卒中患者:复发警示症状感知水平有待提高,感知复发严重且能自觉反思,复发担忧、疾病控制无力感与无用感交织;多次复发脑卒中患者:社会参与能力明显下降,质疑行为改变益处,积极或消极接受复发且生死观话题突出。结论首发与复发脑卒中患者的疾病体验和复发风险感知水平不同,普遍存在复发风险意识不足的现象,建议根据发作次数设计分类健康指导方案,关注复发风险并实施风险沟通教育,提高脑卒中患者疾病认识和复发风险感知水平。Objective To gain insights into the perception of the disease experience and recurrence risk from the perspective of patients who experienced first-ever and recurrent stroke. Methods A phenomenological approach was conducted and a total of 19 stroke survivors were enrolled for semi-structural in-depth interviews. Colaizzi method was used to analyze the data. Results The abstraction process generated 3 categories according to the number of recurrences,which showed different characteristics. First-ever stroke survivors could identify anomalies but lacked of professional information resources;they could actively seek treatment with awareness of benefits of timely hospitalization;they were overoptimistic towards prognosis and easily overlooked the risk of recurrence. For the patients with a second stroke,adequate information about warning signs was still needed;they perceived the severity of recurrent stroke and aroused self-reproach and self-examination;susceptibility of recurrence,sense of powerlessness and the loss of control were experienced. Regarding to patients with multiple recurrences,their social participation ability significantly decreased;they perceived no visible benefits of behavioral changes;they started to focus on life and death with positive or negative acceptance of recurrence. Conclusion Despite differences of patients,inadequate awareness of recurrence risks is a common phenomenon. It is recommended to develop a classified health guidance according to patients’ recurrence times,to implement risk communication education to promote disease awareness and recurrent risk perception of stroke survivors.

关 键 词：脑卒中 疾病体验 复发风险感知 质性研究 护理 

分 类 号：R473.74[医药卫生—护理学]