慢性阻塞性肺疾病患者社会隔离体验的质性研究  

Experience of social isolation in patients with chronic obstructive pulmonary disease:a qualitative study

作　　者：韩明华 赵倩[2] 罗明月 何亚鹏 张睿涵 薛肖肖 吴红霞[3] HAN Minghua;ZHAO Qian;LUO Mingyue;HE Yapeng;ZHANG Ruihan;XUE Xiaoxiao;WU Hongxia

机构地区：[1]山西医科大学护理学院,太原市030001 [2]山西医科大学附属第五医院/山西省人民医院护理部 [3]山西医科大学附属第五医院/山西省人民医院呼吸与危重症医学科

出　　处：《中华护理杂志》2025年第5期532-539,共8页Chinese Journal of Nursing

基　　金：山西省哲社科课题(2023YY087);山西省中医药管理局科研课题(2022ZYYC072)。

摘　　要：目的探索在社会生态系统理论框架指导下,慢性阻塞性肺疾病患者的社会隔离体验,为临床制订针对性的干预措施提供依据。方法采用目的抽样法,于2024年4月—7月,对山西省某三级甲等医院收治的符合标准的慢性阻塞性肺疾病患者进行半结构式访谈,运用Colaizzi 7步分析法和NVivo 12.0软件对资料进行分析。结果共访谈15例慢性阻塞性肺疾病患者,访谈的总时长为405 min,转录相关主题文字4万余字。共提炼出3个主题、9个亚主题,其中微观系统层面为个体内在体验的复杂交织(躯体功能受限、负性情绪严重、情绪失衡感加剧、社会角色削弱),中观系统层面为家庭与社会网络的支持与挑战(家庭情感支持需求强烈、亲友交往中的社交隔阂增宽、人际沟通障碍凸显),宏观系统层面为社会环境与相关卫生政策的交互影响(居住环境局限、政策支持和服务可及性需求迫切)。结论慢性阻塞性肺疾病患者的社会隔离呈现出多个维度的体验,未来需制订跨学科、多层次的综合干预策略,为患者创造更多社交机会和情感联结,提高患者的生活质量。Objective Under the guidance of the Social Ecosystems Theory(SET)framework,this study explores the experience of social isolation among patients with chronic obstructive pulmonary disease(COPD),providing a basis for the development of targeted clinical interventions.Methods This study employed purposeful sampling methods.Semi-structured interviews were conducted from April to July 2024 with patients diagnosed with COPD at a tertiary hospital in Shanxi Province,China,who met the inclusion and exclusion criteria.Data were analyzed using Colaizzi’s seven-step analysis method and NVivo 12.0 software.Results This study involved in-depth interviews with 15 patients suffering from COPD,totaling approximately 405 minutes of interview time and yielding over 40,000 words in transcribed text.Totally 3 main themes and 9 sub-themes were distilled,among which the microsystem level reflects the intricate interplay of individual experiences(physical functional limitations,severe negative emotions,heightened emotional imbalance,and weakened social roles);the mesosystem level pertains to the support and challenges from family and social networks(intense need for familial emotional support,widening social gaps in interactions with friends and relatives,and pronounced interpersonal communication barriers);the macrosystem level involves the integrated influence of societal and policy environments(restricted living conditions and urgent demands for policy support and service accessibility).Conclusion The social isolation experienced by patients with COPD manifests in multiple dimensions of experience.It is necessary to develop interdisciplinary and multi-level comprehensive intervention strategies for the future,to create more social opportunities and emotional connections for patients,thereby improving their quality of life.

关 键 词：社会生态系统理论 肺疾病 慢性阻塞性 社会隔离 体验 质性研究 护理 

分 类 号：R47[医药卫生—护理学]