无精子症男性行供精辅助生殖技术治疗决策体验的质性研究  

A qualitative study on the decision-making experiences of men with azoospermia undergoing donor sperm-assisted reproductive technology treatment

作　　者：莫凤逸 马青 李颖[1] 程旭珍 郭春烨 邢兰凤[1] Mo Fengyi;Ma Qing;Li Ying;Cheng Xuzhen;Guo Chunye;Xing Lanfeng(Women's Hospital School of Medicine Zhejiang University,Hangzhou Zhejiang 310006,China)

机构地区：[1]浙江大学医学院附属妇产科医院,浙江杭州310006

出　　处：《护理与康复》2025年第4期15-19,共5页Journal of Nursing and Rehabilitation

基　　金：浙江省教育厅一般科研项目,编号Y202454956。

摘　　要：目的探索无精子症男性患者行供精辅助生殖技术治疗时的治疗决策体验,为制定临床教育方案及帮助患者共同参与治疗决策提供参考依据。方法2023年12月至2024年2月采用目的抽样法,选取于浙江大学医学院附属妇产科医院行供精辅助生殖技术助孕治疗的13例无精子症患者进行半结构式访谈,运用Colaizzi七步分析法对访谈资料进行分析、归纳并提炼主题。结果共提炼出3个主题及8个亚主题:决策过程伴有明显负性情绪,包括心理适应过程艰难、自尊低下及对妻子有愧疚感、对治疗结局明显担忧;决策压力大且面临多种决策困境,包括对治疗隐私泄露存在担忧、担心家庭关系受到挑战及对婚姻关系有威胁、对养育过程不确定及担心决策后悔;缺乏有效的决策信息支持,包括供精治疗信息支持不足、伦理及法律知识欠缺。结论行供精辅助生殖技术治疗的男性无精子症患者在决策过程中体验较为复杂,护理人员应结合患者的心理特点、婚姻关系、家庭及社会支持状况等提供个性化的临床教育方案和信息支持,改善其决策体验。Objective To explore the decision-making experiences of men with azoospermia undergoing donor sperm-assisted reproductive technology(ART)treatment and to provide a reference for developing clinical education programs and facilitating shared decision-making with patients.Methods Using purposive sampling,13 patients with azoospermia undergoing donor sperm ART treatment at the Women's Hospital School of Medicine Zhejiang University were recruited from December 2023 to February 2024.Semi-structured interviews were conducted,and the data were analyzed,summarized,and thematically extracted using Colaizzi's 7-step analysis method.Results Three main themes and eight subthemes were identified:decision-making accompanied by significant negative emotions,including feelings of the process of psychological adaptation is challenging,low self-esteem,guilt toward their spouses,and concerns about treatment outcomes;high decision-making pressure and multiple dilemmas,including worries about privacy breaches,challenges to family relationships,threats to marital stability,uncertainties about parenting,and fear of decision regret;lack of effective decision-making support,including insufficient informational support and limited knowledge of ethical and legal aspects.Conclusion Men with azoospermia undergoing donor sperm ART experience complex decision-making processes.Healthcare providers should offer personalized clinical education and informational support tailored to the psychological characteristics,marital relationships,and family and social support systems of these patients.This approach can improve their decision-making experiences.

关 键 词：供精 辅助生殖技术 男性 决策体验 质性研究 

分 类 号：R698.2[医药卫生—泌尿科学]