非酒精性脂肪肝患者自我管理障碍及促进因素的质性研究  

Qualitative Study on Self-management Disorders and Promoting Factors in Patients with Non-alcoholic Fatty Liver Disease

作　　者：肖烨 张雪玲 XIAO Ye;ZHANG Xueling(Department of Nursing,The First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian 350004,China;Department of National Regional Medical Center,The First Affiliated Hospital of Fujian Medical University,Fuzhou,Fujian 350004,China)

机构地区：[1]福建医科大学附属第一医院护理部,福建福州350004 [2]福建医科大学附属第一医院国家区域医疗中心,福建福州350004

出　　处：《中国医药指南》2025年第5期151-154,共4页Guide of China Medicine

基　　金：福建医科大学附属第一医院院级课题(2022FY-HZ-15)。

摘　　要：目的探究非酒精性脂肪肝(NAFLD)患者自我管理的障碍与促进因素,为构建精准的非酒精性脂肪肝患者自我管理干预提供参考依据。方法以目的抽样法选取于2023年5月—7月在福建省某三级甲等综合医院脂肪肝健康管理门诊就诊的12例患者进行半结构式访谈,基于能力-机会-动机-行为模型,运用主题分析法进行资料分析。结果NAFLD患者自我管理的障碍因素主要包括知识与能力因素(相关知识缺乏、躯体活动障碍、较差的自律性)、机会因素(不利的自我管理环境、社会支持效能低下)、动机因素(健康求知怠惰、较低的自我效能、躯体疲劳状态);促进因素包括能力因素(较高的NAFLD自我管理知识水平、较强的自律性)、机会因素(良好的锻炼环境、医护的健康指导)、动机因素(较强的自我效能、较强的自我管理动机)。结论NAFLD患者自我管理受到多种因素的影响,临床医护人员应采取针对性策略促进NAFLD患者提升自我管理水平,以期改善患者临床结局。Objective To explore the obstacles and promoting factors of self-management in patients with non-alcoholic fatty liver disease(NAFLD),and provide reference for constructing precise self-management interventions for non-alcoholic fatty liver disease patients.Methods A total of 12 patients who visited the fatty liver health management clinic at a tertiary general hospital in Fujian Province from May to July 2023 were selected using purposeful sampling.Semi-structured interviews were conducted,and the data were analyzed using thematic analysis based on the Capability-Opportunity-Motivation-Behavior(COM-B)model.Results The barriers to self-management among NAFLD patients mainly include knowledge and ability factors(lack of relevant knowledge,physical activity limitations,poor self-discipline),opportunity factors(unfavorable self-management environment,low social support effectiveness),and motivation factors(health knowledge apathy,low self-efficacy,physical fatigue).The facilitators include ability factors(higher levels of NAFLD self-management knowledge,strong self-discipline),opportunity factors(good exercise environment,health guidance from medical staff),and motivation factors(strong self-efficacy,strong self-management motivation).Conclusions Self management of patients with non-alcoholic fatty liver disease is influenced by multiple factors.Clinical medical staffshould adopt targeted strategies to promote the improvement of self-management level in patients with non-alcoholic fatty liver disease,in order to improve their clinical outcomes.

关 键 词：非酒精性脂肪肝 自我管理 能力-机会-动机-行为模型 质性研究 

分 类 号：R575.5[医药卫生—消化系统] R473.5[医药卫生—内科学]