减重术后患者居家血糖管理促进及阻碍因素的质性研究  

Facilitators and impediments to home glucose management for patients undergoing bariatric surgery:a qualitative study

作　　者：张笑倩 姚琳[1] 王金凤 刘春霞[1] 朱丽华 段晓旭 Zhang Xiaoqian;Yao Lin;Wang Jinfeng;Liu Chunxia;Zhu Lihua;Duan Xiaoxu(General Surgery·Metabolic and Bariatric Center,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院普外科·代谢减重中心,北京100029

出　　处：《中华现代护理杂志》2025年第11期1417-1422,共6页Chinese Journal of Modern Nursing

基　　金：2023年度中日友好医院高水平医院临床业务费专项项目(2023-NHLHCRF-GLMS-26)。

摘　　要：目的基于实施性研究综合框架(CFIR)探讨减重术后患者居家血糖管理的促进和阻碍因素,为减重术后血糖管理路径的制订提供参考依据。方法本研究为描述性现象学研究。采用目的抽样法,于2023年11月—2024年1月选取中日友好医院普外科·代谢减重中心的7名医护人员和11例减重术后患者为研究对象,进行半结构化访谈,采用定向内容分析法进行资料分析。结果共提炼出与CFIR 5个维度相关的6个促进因素和6个阻碍因素。促进因素包括个性化血糖管理方案、长期规律性随访、多学科管理团队、亲友支持、并发症困扰和信息化平台;阻碍因素包括随访模式化、资源的可及性与便捷性差、角色冲突、从众心理、行为依从性欠佳、数字化设备使用率低。结论减重术后患者血糖管理需求不同,管理依从性逐渐下降。医护人员应构建"互联网+"居家血糖管理服务模式,开展针对性的多学科团队随访,促进患者居家血糖管理规范化路径的形成。Objective To explore facilitators and impediments to home glucose management for patients undergoing bariatric surgery based on the consolidated framework for implementation research(CFIR),so as to inform the development of a glucose management pathway after bariatric surgery.Methods This study was a descriptive phenomenological study.Using purposive sampling method,seven healthcare professionals and 11 patients undergoing bariatric surgery from the General Surgery·Metabolic and Bariatric Center of China-Japan Friendship Hospital were selected from November 2023 to January 2024 for semi-structured interviews.Targeted content analysis was used for the data analysis.Results A total of six facilitators and six impediments related to the five dimensions of CFIR were distilled.Facilitators included the personalized glucose management program,regular long-term follow-up,multidisciplinary management team,support from family and friends,complication distress,and information technology platform.Impediments involved patterned follow-up,poor accessibility and convenience of resources,role conflict,herd mentality,poor behavioral compliance,and low utilization of digital equipment.Conclusions Glucose management needs vary in patients after bariatric surgery,with a gradual decline in management compliance.Healthcare professionals should build an"Internet+"home glucose management service model,carry out targeted multidisciplinary team follow-up,and promote the formation of a standardized pathway for patients'home glucose management.

关 键 词：质性研究 减重代谢术 居家康复 血糖管理 实施性研究综合框架 

分 类 号：R473.6[医药卫生—护理学]