心力衰竭患者延迟就医原因的质性研究  

Qualitative study on reasons for delayed medical seeking in patients with heart failure

作　　者：李少玲[1] 卢晓虹[1] 魏丽丽[2] 王立艳[1] 于晓燕[1] 史少婷 曹丽华 张文忠[1] Li Shaoling;Lu Xiaohong;Wei Lili;Wang Liyan;Yu Xiaoyan;Shi Shaoting;Cao Lihua;Zhang Wenzhong(Deparment of Cardiology,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Deparment of Nursing,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院心血管内科,青岛266000 [2]青岛大学附属医院护理部,青岛266000

出　　处：《中华现代护理杂志》2021年第24期3234-3238,共5页Chinese Journal of Modern Nursing

基　　金：山东省医药卫生科技发展计划项目(2017WS316)。

摘　　要：目的:探讨心力衰竭患者延迟就医原因,为引导心力衰竭患者及时就医、增加院内及院外护理范畴、优化护理模式提供新的思路。方法:采用目的抽样法选取2020年6—7月青岛大学附属医院心血管内科延迟就医的心力衰竭患者为研究对象。以"健康生态学模型"为理论基础,对15例患者进行半结构式深入访谈,应用质性研究中的描述现象学分析方法及Nvivo11.0中文版软件辅助分析资料,对访谈资料分析与提炼。结果:15例心力衰竭患者延迟就医时间为7~44 d,延迟就医原因可归纳为5个主题群:症状认知不足;疾病管理能力缺乏;特殊人群的认知和经历;家庭社会支持不足;医疗延迟。结论:医护人员应优化心力衰竭患者健康教育内容及模式,提高心力衰竭患者自我管理能力,及时识别特殊患者并给予针对性干预,探索心力衰竭患者获得院外优质医疗资源支持的途径进而改善延迟就医的发生。Objective To explore the reasons for delayed medical seeking in patients with heart failure,and to provide new ideas for guiding patients with heart failure to seek medical treatment in time,increasing the scope of in-hospital and out-of-hospital nursing and optimizing the nursing mode.Methods Using the purposive sampling method,patients with heart failure who had delayed medical seeking in Department of Cardiovascular Medicine in the Affiliated Hospital of Qingdao University were selected as the research objects from June to July 2020.Based on the theory of"health ecology model",15 patients with heart failure were given semi-structured in-depth interviews.The descriptive phenomenological analysis method in qualitative research and Chinese version of Nvivo11.0 software were used to analyze and refine the interview data.Results The delayed medical treatment time of 15 patients with heart failure was 7 to 44 days.The reasons for delayed medical seeking were summarized into 5 thematic groups,including insufficient symptom cognition,lack of disease management ability,cognition and experience of special population,insufficient family social support and medical delay.Conclusions Medical staff should optimize the content and mode of health education for patients with heart failure,improve the self-management ability of patients with heart failure,timely identify special patients and give targeted intervention,and explore the way for patients with heart failure to obtain the support of high-quality medical resources outside the hospital so as to improve the occurrence of delayed medical treatment.

关 键 词：心力衰竭 延迟就医 质性研究 疾病管理 

分 类 号：R541.6[医药卫生—心血管疾病]