心力衰竭患者心理资源损耗与恢复过程的质性研究  

The process of mental resource depletion and recovery in patients with heart failure:a qualitative research

作　　者：孙姝怡 孙国珍[1] 高敏[2] 王洁[2] 于甜栖 刘沈馨雨 汤志杰 温高芹 SUN Shuyi;SUN Guozhen;GAO Min;WANG Jie;YU Tianxi;LIU Shenxinyu;TANG Zhijie;WEN Gaoqin

机构地区：[1]南京医科大学护理学院,南京市211166 [2]南京医科大学第一附属医院心血管内科

出　　处：《中华护理杂志》2024年第6期706-712,共7页Chinese Journal of Nursing

基　　金：国家自然科学基金(72074124);江苏高校优势学科建设工程项目(JX10631804)。

摘　　要：目的探索心力衰竭患者心理资源损耗与恢复过程的特征。方法基于自我损耗理论,采用描述性现象学研究方法,于2022年9月—11月,对南京市某三级甲等综合医院心血管内科16例心力衰竭患者进行半结构式深度访谈,采用Colaizzi七步法对资料进行分析、提炼。结果共提炼出急性心理损耗源(角色转换导致心理应激、生理痛苦引发心理资源危机),慢性心理损耗源(躯体症状导致原有行为习惯改变、持续的不适症状令患者备受煎熬、不确定性使患者深陷反刍思维、治疗费用加重经济负担),自我损耗表现(消极思维模式与浅层认知加工、复杂交织的负性情绪、行为执行力弱化),心理资源恢复(激发个人成长,实现自我疗愈;多方资源支持,营造复愈性环境)4个主题,11个亚主题。结论心力衰竭患者病程中存在急、慢性损耗源,可导致多种自我损耗表现,损耗与恢复并存且动态变化。医护人员应密切关注心理损耗源对患者的影响,判断自我损耗的表现及严重程度,及时采取恢复措施,维持患者心理资源平衡,提高自我调节能力。Objective To explore the process of mental resource depletion and recovery in patients with heart failure.Methods Based on the ego-depletion theory,using descriptive phenomenology research method,a semi-structured in-depth interview was conducted on 16 patients with heart failure in the cardiovascular ward of a tertiary A general hospital in Nanjing from September to November 2022,and the data were analyzed and refined by the Colaizzi seven-step method.Results 4 themes were extracted:acute ego-depletion sources(including psychological stress caused by role transition,and mental resource crisis caused by physical pain),chronic ego-depletion sources(including physical symptoms leading to changes in old habits,patients suffering from persistent discomfort symptoms,patients mired in rumination due to uncertainty,and the cost of treatment increasing the economic burden),ego-depletion(including negative thinking patterns and shallow cognitive processing,complex mixed adverse emotions,and weak performance of behavior),mental resource recovery(including seeking self-healing and providing a healing environment).Conclusion There are acute and chronic ego-depletion sources in the course of heart failure patients,which can lead to a variety of ego-depletion manifestations,depletion and recovery coexist,and change dynamically.Medical staff should pay attention to the impact of ego-depletion sources on patients,evaluate the performance and severity of ego-depletion,and take timely recovery measures to maintain the balance of patients’mental resource and improve the ability of self-regulation.

关 键 词：自我损耗 自我调节 心理资源 心力衰竭 质性研究 心理护理 

分 类 号：R473.5[医药卫生—护理学]