基于行为改变模型的冠状动脉旁路移植术患者康复行为影响因素的质性研究  

A qualitative study of the influencing factors of postoperative rehabilitation behavior in patients undergoing coronary artery bypass grafting based on the COM-B Model

作　　者：胡媛 马文涓 加依娜尔·木哈台勒 李丽[2] Hu Yuan;Ma Wenjuan;Jiayinaer Muhataile;Li Li(School of Nursing,Xinjiang Medical University,Operating Room,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Urumqi 830000,China)

机构地区：[1]新疆医科大学护理学院,新疆830000 [2]新疆医科大学第一附属医院手术室

出　　处：《中国体外循环杂志》2025年第1期52-57,共6页Chinese Journal of Extracorporeal Circulation

基　　金：自治区卫生与健康适宜技术推广项目(SYTG-Y202321)。

摘　　要：目的探讨冠状动脉旁路移植术患者参与康复行为的影响因素,旨在为心脏康复工作提供参考依据。方法2023年1月至2023年3月,采用目的抽样法选取新疆某三级甲等综合医院18名冠状动脉旁路移植术患者进行半结构化访谈。能力、机会、动机-行为(COM-B)模型用于指导访谈和主题,并将分类数据与COM-B模型的三个关键领域(能力、机会、动机-行为)相关联,以评估其相关因素。结果完成了18次访谈,数据达到饱和。冠状动脉旁路移植术患者康复行为影响因素分别来自能力因素(运动强度耐受、康复认知不足)、机会因素(同伴支持效应、专业指导欠缺、复查随访不便)、动机因素(有益康复行为感知、应激负性情绪触发、康复环境需求)三方面。结论冠状动脉旁路移植术患者在参与康复行为方面受多种因素的影响。医务人员在为其制订个性化的运动康复方案时,加强疾病宣教,构建有效支持系统,为其创建良好康复环境,以提高患者对康复锻炼的依从性,从而促进患者康复行为的改善。Objective To explore the factors influencing the participation of coronary artery bypass graft(CABG)patients in rehabilitation behaviour and to provide a reference for cardiac rehabilitation.Methods From January 2023 to March 2023,18 patients undergoing CABG in a grade 3,class A general hospital in Xinjiang were selected for semi-structured interview.Ability,opportunity,and motivation-behavior(COM-B)model were used to guide interviews and topics and to associate categorical data with three key domains(competence,opportunity,motivation-behavior)of the COM-B model to assess its associated factors.Results After completing 18 interviews,the data reached saturation.Factors influencing rehabilitation behavior of patients undergoing CABG came from ability factors(exercise intensity tolerance,rehabilitation cognitive deficiency),opportunity factors(peer support effect,lack of professional guidance,review follow-up inconvenience),motivation factors(beneficial rehabilitation behavior perception,stress negative emotional trigger,rehabilitation environment demand),respectively.Conclusion Patients undergoing CABG are affected by many factors for participating in rehabilitation behavior.When formulating personalized sports rehabilitation programs for them,medical staff should strengthen disease education,build an effective support system,and create a good rehabilitation environment for them,and to improve patients’compliance with rehabilitation exercise,so as to promote the improvement of patients’rehabilitation behavior.

关 键 词：冠状动脉旁路移植术 COM-B模型 康复行为 影响因素 质性研究 

分 类 号：R47[医药卫生—护理学]