维持性血液透析患者高磷血症自我管理真实体验的质性研究  

Qualitative study on the real experiences of self-management of hyperphosphatemia in maintenance hemodialysis patients

作　　者：赵丹[1] 刘婷婷[1] 陶幸娟 王敏[3] 赵诗宇 章海芬[1] 奚慧琴[1] 杨艳 Zhao Dan;Liu Tingting;Tao Xingjuan;Wang Min;Zhao Shiyu;Zhang Haifen;Xi Huiqin;Yang Yan(Department of Nursing,Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院护理部,上海200127 [2]上海交通大学护理学院 [3]上海交通大学医学院附属仁济医院肾脏科

出　　处：《护理学杂志》2023年第20期31-35,共5页Journal of Nursing Science

基　　金：上海交通大学医学院2021年护理学科人才队伍建设项目(SHSMU-ZDCX2021800)。

摘　　要：目的 深入了解维持性血液透析患者高磷血症自我管理的真实体验,为临床护理实践提供参考。方法 对13例维持性血液透析高磷血症患者进行半结构式访谈,采用内容分析法对资料进行编码、分析和提炼主题。结果 共提炼出身心困扰(瘙痒、无力感、自我感受负担、疾病不确定感),决策困境(血磷管理困境、希望掌控生活主动权、希望血磷控制在合理水平、基于自我感受的管理策略),转变行为(认知的积累与转变、积极自我监测、调动家庭资源、寻求医护或同伴支持)3个主题及12个亚主题。结论 维持性血液透析高磷血症患者的自我管理体验复杂,护理人员应针对其需求与体验实施针对性干预,协助患者将血磷控制在正常水平。Objective To gain an in-depth understanding of the lived experiences of self-management of hyperphosphatemia in maintenance hemodialysis patients,and to provide reference for clinical nursing practice.Methods Semi-structured interviews were conducted with 13 maintenance hemodialysis patients experiencing hyperphosphatemia.Data were analyzed and coded using content analysis.Results Three main themes and twelve subthemes emerged:psychological and physical distress(itch,powerlessness,self-perceived burden,and illness uncertainty);decision dilemmas(challenges in phosphorus management,desire for life control,desire for control of phosphorus levels,and management strategies based on self-perception);and behavior change(cognition accumulation and transformation,active self-monitoring,mobilization of family resources,and seeking medical or peer support).Conclusion The self-management experience of patients with hyperphosphatemia on maintenance hemodialysis is complex.Nursing staff should provide targeted interventions to meet their demands,and assist patients to maintain phosphorus levels within the normal range.

关 键 词：终末期肾病 维持性血液透析 高磷血症 自我管理 真实体验 质性研究 

分 类 号：R473.5[医药卫生—护理学]