颈动脉狭窄患者首次支架术后过渡期自我管理体验的质性研究  

Qualitative study on self-management experience of patients with carotid artery stenosis during the tran⁃sition period after first-time CAS

作　　者：孙芳芳 陈霞 崔新 侯晓红 徐忠凤 SUN Fangfang;CHEN Xia;CUI Xin;HOU Xiaohong;XU Zhongfeng(Department of Neurology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Nursing,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Critical Care Medicine,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属省立医院东院神经内科,山东济南250021 [2]山东第一医科大学附属省立医院东院护理部,山东济南250021 [3]山东第一医科大学附属省立医院东院重症医学科,山东济南250021

出　　处：《老年医学研究》2021年第3期27-31,共5页Geriatrics Research

摘　　要：目的了解颈动脉狭窄患者首次行颈动脉支架植入术(CAS)治疗后过渡期自我管理的情况,为制定CAS治疗后延续照护模式提供参考依据。方法选取15例首次行CAS的颈动脉狭窄患者为调查对象,采用半结构式深入访谈法对其CAS术后过渡期自我管理体验情况进行深度访谈。根据现象学Colaizzi七步法对访谈资料进行分析,并提取、汇总重要陈述,构建出意义单元,形成主题雏形,最后归纳整理提炼出主题。结果首次行CAS患者术后过渡期自我管理体验可归纳为3个主题和9个亚主题:疾病管理技能低(用药知识欠缺、康复需求未满足、症状识别能力不足)、生活管理依从性差(饮食知识片面、运动量不足、戒除烟酒困难)、心理调控能力弱(自我矮化、自我感受负担重、担忧疾病预后)。结论首次行CAS患者存在多方面的自我管理缺陷,医护人员应该深入分析患者缺乏自我管理能力的原因,采取相应的对策充分调动患者自我管理的主动性和积极性。Objective To understand self-management experience of patients with carotid artery stenosis in the tran⁃sition period after the first carotid artery stenting(CAS)treatment,in order to provide reference for the development of con⁃tinuous care mode after CAS treatment.Methods Totally 15 patients with carotid stenosis who underwent CAS for the first time were selected as the research objects.Semi structured in-depth interview was used to conduct in-depth interview on their self-management experience in the transitional period after CAS.According to the Colaizzi seven step method of phenomenology,this paper analyzes the interview data,extracts and summarizes the important statements,constructs the meaning unit,forms the theme prototype,and finally summarizes and refines the theme.Results Three themes with nine sub-themes were extracted,including the low disease management skills(lack of medication knowledge,unsatisfied rehabilitation needs,insufficient ability to recognize symptoms),poor compliance with life management(one-sided dietary knowledge,insufficient exercise,difficulty in quitting smoking and alcohol),weak psychological adjustment ability(the self-dwarfing,heavy self-perceived burden,worrying about the disease prognosis).Conclusion Patients undergoing CAS for the first time have different self-management deficiencies.Medical staff should deeply analyze the reasons for the patients'lack of self-management ability,and take corresponding measures to fully mobilize the initiative and enthusiasm of patients'self-management.

关 键 词：颈动脉支架植入术 颈动脉狭窄 过渡期 延续照护 自我管理 质性研究 

分 类 号：R743[医药卫生—神经病学与精神病学] R473.74[医药卫生—临床医学]