肠瘘患者居家康复体验的质性研究  

Qualitative study on home rehabilitation experience of patients with intestinal fistula

作　　者：王少霞 张红梅[2] 王志霞[2] 宋笑飞[2] 杜灿灿 WANG Shaoxia;ZHANG Hongmei;WANG Zhixia;SONG Xiaofei;DU Cancan(Zhengzhou University People's Hospital,Zhengzhou 450000,Henan,China;Henan Provincial People's Hospital,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学人民医院,河南郑州450000 [2]河南省人民医院,河南郑州450000

出　　处：《护士进修杂志》2023年第2期154-159,共6页Journal of Nurses Training

基　　金：河南省科技攻关基金资助项目(编号:182102310149)。

摘　　要：目的深入探究肠瘘患者居家康复期间的真实体验,为构建肠瘘患者延续性居家护理干预策略提供参考依据。方法采用目的抽样的方法,选取我院15例肠瘘患者,在复查期间进行半结构式访谈,最后运用Colaizzi 7步分析法归纳主题。结果根据肠瘘患者居家康复体验情况,归纳出3个主题:(1)居家康复复杂的情感变化(角色转变后的挑战,瘘口久治不愈的焦虑与恐惧、自我病耻感强烈和对生命的敬畏与感恩之情)。(2)居家患者疾病的自我管理能力(对肠瘘相关专业知识和认知的缺乏、症状评估及应对能力较弱)。(3)居家康复的期望与需求(对延续性护理方式多样化的需求、对社会支持的渴望)。结论多数肠瘘患者居家康复体验的情况不容乐观,居家康复患者的情感往往存在两极化,且自我管理疾病的能力不足,对居家的延续性护理的需求大。同时对医院、政府和社会的支持需求也相当明显。基于以上问题,本研究认为临床医护人员应制定差异化的心理干预措施,保障居家康复患者身心健康;强化出院计划的实施,提高患者对肠瘘的认知和居家康复的自我管理能力;还可通过构建持续专业的智慧居家护理平台与社会保障系统,完善患者居家康复需求,以优化肠瘘患者居家康复的体验,从而实现患者的早日康复。Objective To deeply explore the real experience of patients with intestinal fistula during home rehabilitation to provide reference for the construction of continuous home care intervention strategies for patients with intestinal fistula.Methods Using the method of objective sampling,15 patients with intestinal fistula in a tertiary hospital in Henan province were selected,and semi-structured interviews were conducted during the review period.Finally,the Colaizzi seven-step analysis method was used to summarize the topic.Results According to the home rehabilitation experience of patients with intestinal fistula,three themes are summarized:(1)Complex emotional changes in home rehabilitation(challenges after role change,anxiety and fear of long-term healing of fistula,strong sense of self-stigma,and awe and gratitude for life);(2)The self-management ability of patients at home(lack of professional knowledge and cognition about intestinal fistula,weak symptom assessment and coping ability);(3)Expectations and needs of home rehabilitation(various ways of continuous care demand for socialization,desire for social support).Conclusion The home rehabilitation experience of most intestinal fistula patients is not optimistic.The emotions of home rehabilitation patients are often polarized,and the ability to self-manage the disease is insufficient,and there is a great demand for continuous home care.At the same time,the demand support for hospitals,government and society is also quite obvious.Based on the above problems,this study believes that clinical medical staff shall formulate differentiated psychological intervention measures to protect the physical and mental health of home-based rehabilitation patients;Strengthen the implementation of discharge plans to improve patients'awareness of intestinal fistulas and self-management capabilities of home-based rehabilitation;By building a continuous and professional smart home care platform and social security system,the patient's home rehabilitation needs are improved,the hom

关 键 词：肠瘘 居家康复 体验 质性研究 互联网+ 家庭护理(专业) 

分 类 号：R473.57[医药卫生—护理学]