携带埋藏式心脏起搏器患者心理韧性成长的质性研究  

A qualitative study of psychological resilience growth in patients with implantable pacemaker

作　　者：李慧 柏晓玲 杨曾桢 逄锦 郭世鸿 LI Hui;BAI Xiaoling;YANG Zengzhen;PANG Jin;GUO Shihong(Department of Critical Care Medicine,Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou,China;Guizhou Nursing Vocational college,Guiyang 550022,Guizhou,China;School of Nursing,Guizhou University of Traditional Chinese Medicine,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院重症医学科,贵州贵阳550002 [2]贵州护理职业技术学院,贵州贵阳550022 [3]贵州中医药大学护理学院,贵州贵阳550002

出　　处：《护士进修杂志》2024年第16期1739-1743,1748,共6页Journal of Nurses Training

基　　金：贵州省卫生健康委科学技术基金项目(编号:gzwkj2021-480)。

摘　　要：目的了解携带埋藏式心脏起搏器(pacemakers,PM)患者出院后的心理韧性体验,深度探究其感受变化过程。方法采用目的抽样法,于2021年10月-2022年5月选取我院起搏器随访门诊的11例携带PM患者,采用现象学研究法进行半结构式访谈,运用Colaizzi 7步分析法借助NVivo软件对访谈资料进行分析并提炼主题。结果共经历2个时期,各时期分别提炼出5个主题:植入第1个月的心理韧性建立危机期(无奈、强烈的不确定感、心理机能调节失衡、自我形象受损、渴求康复锻炼的指导)。植入第6个月的心理韧性调控期(调整与适应变化,接纳现状;重塑认知;生活态度的调节;延续护理服务及医疗技术的空缺;渴望获取疾病管理信息)。结论建议医护人员依据患者在不同时期的心理韧性特点,分类制定携带PM患者的术后管理方案,重视植入初期心理韧性建设的影响因素,注重患者心理发展形势,强化术后患者的信息与情感支持,持续关注术后调控期康复患者的心理韧性,发挥其带动同伴患者的优势作用。Objective To understand the mental toughness experience of patients with pacemakers(PM)after discharge,and to deeply explore the change process of their feelings.Methods From October 2021 to May 2022,11 patients with PM at the PM follow-up clinic of our hospital were selected as the study objects by destination sampling method,and semi-structured interviews was conducted by phenomenological research method,and Colaizzi 7-step method was used to analyze the interview data with NVivo software and distillate the topic.Results A total of 2 periods were experienced,and 5 themes were extracted from each period:the crisis period of mental toughness building in the first month of implantation(helplessness,strong uncertainty,imbalance of mental function regulation,self-image impairment,and longing for guidance of rehabilitation exercise);Control period of psychological resilience in the sixth month of implantation(adjustment and adaptation to change,acceptance of the status quo,reshaping cognition,adjustment of life attitude,continuation of nursing services and gaps in medical technology,and desire to obtain disease management information).Conclusion It is recommended that medical staff make postoperative management plans for PM patients according to the psychological toughness characteristics of patients in different periods,pay attention to the factors affecting the construction of psychological toughness in the initial stage of implantation,pay attention to the psychological development of patients,strengthen the information and emotional support of postoperative patients,and continue to pay attention to the psychological toughness of patients recovering from the postoperative regulation period,and take advantage of its role in promoting peer patients.

关 键 词：埋藏式心脏起搏器 缓慢性心律失常 心理韧性 质性研究 护理 

分 类 号：R473.54[医药卫生—护理学]