基于理论域框架的医护人员实施冠状动脉旁路移植术后Ⅰ期心脏康复障碍感知的质性研究  

Perceived Barriers to the Implementation of Phase Ⅰ Cardiac Rehabilitation after Coronary Artery Bypass Grafting by Health Professionals:A Qualitative Study on Theoretical Domain Framework

作　　者：蔡梦怡 杨芳芳 王小芳[3] 崔苏敏 朱颖[5] 张伟英[6] CAI Mengyi;YANG Fangfang;WANG Xiaofang;CUI Sumin;ZHU Ying;ZHANG Weiying(School of Medicine,Tongji University,Shanghai 200092,China;VIP Department,East Hospital Affiliated to Tongji University,Shanghai 200120,China;Department of Cardiac Surgery,East Hospital Affiliated to Tongji University;Department of Nursing,Renji Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200001,China;School of Nursing,Soochow University,Jiangsu Province,China,215008,China;Department of Nursing,East Hospital Affiliated to Tongji University)

机构地区：[1]同济大学医学院,上海200092 [2]同济大学附属东方医院特诊部,上海200120 [3]同济大学附属东方医院心外科 [4]上海交通大学附属仁济医院护理部,上海200001 [5]苏州大学护理学院,江苏苏州215008 [6]同济大学附属东方医院护理部

出　　处：《军事护理》2024年第8期86-90,共5页MILITARY NURSING

基　　金：上海市浦东新区卫生系统重要薄弱学科建设项目资助(PWZbr2022-04);同济大学医学院学科建设三年行动计划重点学科项目(JS2210103);浦东新区卫生系统领先人才培养计划(PWRl 2020-10)。

摘　　要：目的探讨医护人员实施冠状动脉旁路移植术(coronary artery bypass grafting,CABG)后Ⅰ期心脏康复的障碍感知,为后续针对性干预提供依据。方法采用描述性质性研究方法,基于理论域框架设置访谈提纲,以目的抽样法选取15名医护人员进行半结构访谈,采用框架内容分析法对访谈资料进行整理和分析。结果结合理论域框架,分析得出医护人员实施CABG术后Ⅰ期心脏康复的障碍感知主题:知识缺乏、技能缺乏、职业界限模糊、专业自信不足、预期评价不佳及患者配合程度不足、目标不坚定、认知负荷、资源匮乏及环境互动不佳、组织氛围及社会支持缺乏、消极影响、实施流程及监管措施缺失和习惯改变困难。结论医护人员实施CABG术后Ⅰ期心脏康复的障碍因素具有多样性,本研究归纳的目标领域的主题内容可为心脏康复管理策略和临床实践方案的制定和改进提供参考。Objective To explore the perceived barriers in the implementation of phaseⅠcardiac rehabilitation after coronary artery bypass grafting(CABG)in health professionals,and to provide references for targeted intervention.Methods The study was carried out with descriptive qualitative methodology through semi-structured interviews based on the theoretical domain framework(TDF),after interviewing 15 selected medical staff,and the data were collected and analyzed through content analysis.Results Findings showed that with TDF,perceived themes of barriers for healthcare professionals to implement phase I cardiac rehabilitation after CABG included the lack of knowledge,lack of skills,blurring of professional boundaries,lack of professional self-confidence,poor evaluation of expectations and inadequate patient cooperation,lack of commitment to the goal,cognitive load,lack of resources and poor environmental interaction,lack of organizational climate and social support,negative influences,lack of implementation processes and monitoring measures and difficulty in changing habits.Conclusions There are multiple factors affecting health professionals’implementation of phaseⅠcardiac rehabilitation after CABG,which can provide reference for the development and improvement of cardiac rehabilitation management strategies and clinical practice protocols.

关 键 词：理论域框架 冠状动脉旁路移植术 心脏康复 障碍因素 质性研究 

分 类 号：R473.6[医药卫生—护理学]