膀胱癌根治性切除术后患者性困扰的质性研究  

A qualitative study on the sexual experiences of bladder cancer patients after radical cystectomy

作　　者：杨婷 杨帆[2] Yang Ting;Yang Fan(Department of Nursing,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院护理部,湖北武汉430030 [2]华中科技大学同济医学院附属同济医院泌尿外科,湖北武汉430030

出　　处：《护理学杂志》2025年第4期77-80,91,共5页Journal of Nursing Science

摘　　要：目的探讨膀胱癌根治性切除术后患者性生活面临的困难和需求,为改善术后性生活质量提供参考。方法采用现象学研究方法,对15例膀胱癌根治性切除术后患者进行半结构式深度访谈,运用Colaizzi七步分析法提炼主题。结果共提炼出4个主题,14个亚主题:性困扰症状明显(性功能障碍、性生活中断);负性情绪困境(自尊心和自信心降低、焦虑和抑郁、对性生活恐惧和回避);婚姻关系发生多重改变(亲密关系减少、沟通障碍、夫妻角色转变、伴侣的理解和支持);积极应对方式与性康复需求(主动寻求医疗帮助、尝试替代方式、心理调适、与伴侣共同面对、期待性康复专业指导)。结论膀胱癌根治性切除术后患者性生活面临多方面困扰,医护人员应重视患者的性健康需求,提供个体化的性康复指导和心理支持,改善患者性生活质量。Objective To explore the sexual experience of patients with bladder cancer after radical cystectomy,to understand their difficulties and needs,and to provide reference for improving their sexual life quality after surgery.Methods A semi-structured in-depth interview was conducted in 15 patients with bladder cancer after radical cystectomy using phenomenological research method.The topic was extracted by Colaizzi 7-step analysis method.Results A total of 4 themes and 14 sub-themes were extracted:obvious symptoms of sexual distress(sexual dysfunction,interruption of sexual life);negative emotional distress(reduced self-esteem and self-confidence,anxiety and depression,fear and avoidance of sexual life);multiple changes in marital relationship(reduced intimacy,communication barriers,role changes,partner′s understanding and support);positive coping strategies and sexual rehabilitation needs(actively seeking medical help,trying alternative methods,psychological adjustment,facing challenges together with partners,expecting professional guidance on sexual rehabilitation).Conclusion The sexual life of patients after radical cystectomy is plagued by many aspects.Medical staff should pay attention to the sexual health needs of patients,provide individualized sexual rehabilitation guidance and psychological support,and improve the sexual life quality of patients.

关 键 词：膀胱癌 根治性膀胱切除术 性功能障碍 性生活 性困扰 负性情绪 性康复 质性研究 

分 类 号：R473.6[医药卫生—护理学]