膀胱癌输尿管皮肤造口患者夫妻疾病沟通体验的质性研究  

Disease Communication Experience Between Couples in Bladder Patients Undergoing Cutaneous Ureterostomy:A Qualitative Study

作　　者：张梦冉 王丽晓 李孟明 刘阳阳[2] ZHANG Mengran;WANG Lixiao;LI Mengming;LIU Yangyang(Department of Urinary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Rehabilitation Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院泌尿外科,河南郑州450000 [2]郑州大学第一附属医院康复医学科,河南郑州450000

出　　处：《河南医学研究》2025年第1期29-34,共6页Henan Medical Research

基　　金：河南省高等学校重点科研项目计划(20A320048)。

摘　　要：目的深入探索膀胱癌输尿管皮肤造口患者夫妻疾病沟通中的真实感受和心理体验,为进一步促进夫妻间有效沟通,增强应对疾病的能力提供依据。方法采用目的抽样法,选取2021年5—11月在郑州大学第一附属医院泌尿外科住院治疗的12例膀胱癌输尿管皮肤造口患者,运用现象学研究方法,对其进行半结构式访谈,并运用Colaizzi 7步分析法进行分析。结果膀胱癌输尿管皮肤造口患者夫妻疾病沟通体验共提炼4个主题及10个亚主题:夫妻疾病沟通过程中回避敏感话题(回避个人情感及内心感受的沟通、回避生死或生命时限有关的敏感话题)、回避型沟通对患者产生不良影响(负性情绪得不到有效宣泄、产生疏离感、自信心下降、患者疾病的应对能力下降)、患者创伤后成长且获得积极沟通体验(康复期沟通主动性增强、沟通默契增强且亲密关系改善)、期待专业指导(疾病知识指导、沟通技能培训)。多维度展现了患者夫妻疾病沟通体验。结论患者在夫妻疾病沟通过程中存在不同阶段的沟通困境及指导需求,医务人员应通过疾病专业知识指导及心理干预以帮助其更好地应对压力。Objective To explore the real feelings and psychological experiences of disease communication between bladder patients undergoing cutaneous ureterostomy and their spouses,in order to further promote effective communication between husband and wife,enhance the ability to cope with disease.Methods Purposive sampling method was used to select bladder patients undergoing cutaneous ureterostomy from May to November 2021 in the First Affiliated Hospital of Zhengzhou University for semi-structured interviews.Data was analyzed by Colaizzi 7-step analysis method.Results Four themes and ten sub themes were extracted from the disease communication experience of patients with bladder cancer ureteral dermatostomy:avoid sensitive topics during communication between husband and wife(including avoidance of personal emotions and inner feelings,avoidance of life and death or time limits),avoidant communication has a negative impact on patients(including negative emotions that cannot be effectively expressed,a sense of alienation,the decline of self-confidence,the decline of the ability to cope with the disease),posttraumatic growth and positive communication experience(including the increased of communication initiative,the increased of the sense of tacit understanding,the improved of intimate relationships),expectation of professional guidance(including disease knowledge guidance,communication skills training).Multi-dimensional display of patient and couple disease communication experience.Conclusion Spouses have communication difficulties and guidance needs at different stages in the process of disease communication.Medical staff should help patients and their spouses cope with pressure in environmental events of bladder cancer through disease professional knowledge guidance and psychological intervention.

关 键 词：膀胱癌 输尿管皮肤造口 疾病沟通 质性研究 

分 类 号：R694[医药卫生—泌尿科学]