心脏移植受者出院后过渡期体验的质性研究  

A qualitative study of post-discharge transition experience in heart transplant recipients

作　　者：邢冰玉 缪群芳[2] 冯洁惠[3] 高春华[4] 舒婉 Xing Bingyu;Miao Qunfang;Feng Jiehui;Gao Chunhua;Shu Wan(School of Nursing,Hangzhou Normal University,Hangzhou 311121,China;School of Clinical Medicine,Hangzhou Normal University,Hangzhou 311121,China;Cardiac and Vascular Surgery Department,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Intensive Care Unit,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]杭州师范大学护理学院,杭州311121 [2]杭州师范大学附属医院临床医学院,杭州311121 [3]浙江大学医学院附属第一医院心脏大血管外科,杭州310003 [4]浙江大学医学院附属第一医院ICU,杭州310003

出　　处：《中华现代护理杂志》2022年第16期2178-2182,共5页Chinese Journal of Modern Nursing

摘　　要：目的基于梅莱斯过渡理论,了解心脏移植受者术后出院到居家护理的过渡,为提高受者生活质量提供依据。方法2021年7月,采用目的抽样法选取浙江大学医学院附属第一医院心脏移植受者为研究对象,后采用滚雪球的方式共选取12例心脏移植术后满1年的受者进行半结构访谈,并用Colaizzi 7步法对访谈资料进行分析。结果通过阅读、分析、整理归纳,提炼出4个主题和11个子主题,即身体状态恢复较稳定,缺乏用药及情绪管理(用药认知及管理需求未满足、良好的身体状态、早期脆弱性情绪体验);家庭、社会资源的支持影响过渡(病友的交流与支持促进过渡、家庭的支持促进过渡、社区资源的缺乏阻碍过渡、报销政策影响过渡);过渡中形成积极体验(有信心应对未来生活,回归社会、实现自我价值);期望得到身心全方位延续性管理(以心理健康为中心的护理需求、专业管理团队和医护患沟通平台的需求)。结论出院后居家自我护理的经历给心脏移植受者带来诸多身心影响,应关注过渡期受者的独特体验,构建全社会支持系统给予心脏移植特殊群体更多帮助。Objective To explore the transition from hospital discharge to home care in heart transplant recipients based on the Meleis'transition theory,so as to provide a basis for improving the quality of life of recipients.Methods In July 2021,purposeful sampling was used to select heart transplant recipients from the First Affiliated Hospital of Zhejiang University School of Medicine as the research subject.A total of 12 recipients of one year after heart transplantation were selected for semi-structured interviews by snowballing.The interview data were analyzed using the Colaizzi 7-step method.Results Through reading,analysis,sorting and summarizing,4 themes and 11 sub-themes were extracted,namely,relatively stable recovery of physical condition,lack of medication and emotional management(unmet needs for medication cognition and management,good physical condition,early emotional experience of vulnerability),the support of family and social resources affected the transition(the communication and support of patients promoted the transition,the support of the family promoted the transition,the lack of community resources hindered the transition,and the reimbursement policy affected the transition),a positive experience in the transition(confidence to deal with future life,return to society and self-realization),and expecting to obtain comprehensive and continuous management of body and mind(the needs of nursing care centered on mental health,the needs of professional management teams and the communication platform among doctors,nurses and patients).Conclusions The experience of home self-care after discharge has many physical and psychological impacts on heart transplant recipients.It is necessary to pay attention to the recipients in the transition period,and to build a whole-of-society support system to give help to heart transplant recipients.

关 键 词：心脏移植 过渡 梅莱斯过渡理论 质性研究 

分 类 号：R473.6[医药卫生—护理学]