加速康复外科模式下肺结节日间手术患者围手术期就医体验交互地图的研究  

Study on interactive journey map of perioperative medical experience of patients undergoing pulmonary nodule day surgery under enhanced recovery after surgery mode

作　　者：吴美 夏露[1] 张莉[1] 顾芬 沈晓咏 陈龙[4] WU Mei;XIA Lu;ZHANG Li;GU Fen;SHEN Xiaoyong;CHEN Long(Day Surgery Ward,Huadong Hospital,Fudan University,Shanghai 200040,P.R.China;Department of Nursing,Huadong Hospital,Fudan University,Shanghai 200040,P.R.China;Department of Thoracic Surgery,Huadong Hospital,Fudan University,Shanghai 200040,P.R.China;Medical Affair Department,Huadong Hospital,Fudan University,Shanghai 200040,P.R.China)

机构地区：[1]复旦大学附属华东医院日间手术病房,上海200040 [2]复旦大学附属华东医院护理部,上海200040 [3]复旦大学附属华东医院胸外科,上海200040 [4]复旦大学附属华东医院医务一处,上海200040

出　　处：《华西医学》2025年第2期276-281,共6页West China Medical Journal

基　　金：上海市医院协会医院管理课题(X2024173);上海申康医院发展中心市级医院临床科技创新项目(SHDC12021637);华东医院(护理)新秀人才计划(HLXX2202)。

摘　　要：目的基于患者旅程地图,识别肺结节日间手术患者在加速康复外科模式下围手术期就医交互体验中的需求,为优化该人群疾病诊疗体验及以患者为中心的医疗支持提供借鉴。方法运用描述性质性研究方法,于2024年1月—6月在复旦大学附属华东医院日间手术病房选取15名行胸腔镜下肺结节根治术的患者进行半结构化访谈,采用定向内容分析法进行资料分析并绘制患者就医体验交互地图。结果按就医流程及围手术期阶段,形成患者就医体验交互地图,并从交互触点、信息流动、沟通方式和反馈机制4个环节将肺结节日间手术患者的就医体验和健康支持需求分类归纳为就医提示、医疗信息甄别、多学科评估讨论、医患认知差异、康复锻炼及运动、营养管理、医患沟通、社会调适、情绪表现等主题。结论肺结节日间手术患者经历加速康复外科模式下的围手术期就医流程,其住院周期缩短而健康管理需求复杂。其中产生的就医体验交互触点交织变化,所需的健康支持需求在不同阶段干预点不同,优化触点可以保证患者有需求时获得高效的医疗支持,得以提升患者体验、改善就医感受,使优质护理服务贯穿于各环节中。Objective To identify the needs of patients undergoing pulmonary nodule day surgery during the perioperative medical interaction experience under the enhanced recovery after surgery mode based on the patient journey map,and to provide references for optimizing the diagnosis and treatment experience of these patients and the patient-centered medical support.Methods Using the descriptive qualitative research method,15 patients who underwent thoracoscopic pulmonary nodule resection or pulmonary wedge resection in the day surgery ward of Huadong Hospital,Fudan University between January and June 2024 were selected for semi-structured interviews.The data were analyzed using the content analysis method,and the interactive map of the patient’s medical seeking experience was drawn.Results According to the medical seeking process and perioperative stages,the interactive journey map of the patient’s medical seeking experience was formed.The medical seeking experience and health support needs of patients undergoing pulmonary nodule day surgery were classified and summarized into themes such as medical consultation cues,screening of medical information,multidisciplinary assessment,medical-patient cognitive differences,rehabilitation exercises and sports,nutritional management,doctor-patient communication,social adaptation,and emotional expression from four links:interaction touchpoints,information flow,communication methods,and feedback mechanisms.Conclusions Patients undergoing pulmonary nodule day surgery experience the perioperative medical seeking process under the enhanced recovery after surgery mode,with a shortened hospitalization period but complex postoperative health management needs.The interaction touchpoints generated during the experience are intertwined and changeable,and the health support needs required vary at different stages of intervention points.Optimizing the touchpoints can ensure that patients receive efficient medical support when needed,thereby enhancing the patient experience,improving the med

关 键 词：患者旅程地图 肺结节 日间手术 患者体验 加速康复外科 

分 类 号：R473.6[医药卫生—护理学]