减重代谢术后患者皮肤管理困境的质性研究  

Skin management dilemmas in patients undergoing bariatric metabolic surgery:a qualitative study

作　　者：贾锋[1] 朱晓娟[1] 和青森 郝阳 白东艳 Jia Feng;Zhu Xiaojuan;He Qingsen;Hao Yang;Bai Dongyan(First Gastrointestinal Ward of General Surgery,Nanyang Central Hospital,Nanyang 473009,China;First Neurological Intensive Care Unit,Nanyang Central Hospital,Nanyang 473009,China;Sixth Ward of General Surgery,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473007,China)

机构地区：[1]南阳市中心医院普通外科胃肠一病区,南阳473009 [2]南阳市中心医院神经重症一病区,南阳473009 [3]南阳医专第一附属医院普通外科六病区,南阳473007

出　　处：《中华现代护理杂志》2025年第11期1436-1441,共6页Chinese Journal of Modern Nursing

摘　　要：目的了解减重代谢术后患者皮肤管理中的困境,为构建患者皮肤管理方案提供参考依据。方法本研究为现象学研究,采用目的抽样法,选取2024年3—5月于南阳市中心医院复诊的18例减重代谢术后患者为研究对象,进行面对面半结构化深入访谈。采用Colaizzi现象学资料7步分析法对访谈资料进行整理分析。结果共提炼出3个主题、10个亚主题,分别为自我应对困难(难以应对皮肤症状带来的身体不适、生活困扰和负性情绪困扰);社会支持不足(遭遇家人冷暴力、遭受社交孤立、专业人员支持不足、信息共享受限);减重塑形决策困难(认知不足、并发症担忧和经济困难)。结论减重代谢术后患者皮肤管理过程中面临多重困境,医护人员应根据患者面临的具体问题制订有针对性的皮肤管理方案,提高患者对皮肤管理的重视和自我管理能力,维持身心健康。Objective To explore the dilemmas in skin management of patients undergoing bariatric metabolic surgery,so as to provide a reference for constructing a skin management program.Methods This study was a phenomenological study.Using purposive sampling method,18 patients who underwent bariatric metabolic surgery and had follow-up visits at Nanyang Central Hospital from March to May 2024 were selected for face-to-face semi-structured in-depth interviews.The interview data were organized and analyzed using the Colaizzi seven-step analysis of phenomenological data.Results A total of three themes and ten sub-themes were extracted,namely,difficulties in self-coping(difficulties in coping with physical discomfort,life distress and negative emotional distress caused by skin symptoms),insufficient social support(experiencing cold violence from family members,suffering from social isolation,insufficient support from professionals,and limited information sharing),and difficulties in decision-making for weight loss and body contouring(cognitive deficits,concerns about complications,and financial difficulties).Conclusions Patients undergoing bariatric metabolic surgery face multiple dilemmas during skin management.Healthcare professionals should develop targeted skin management programs based on the specific problems faced by patients to increase patients'attention to skin management and their ability to self-manage and maintain their physical and mental health.

关 键 词：质性研究 肥胖症 减重代谢手术 皮肤管理 困境 

分 类 号：R473.6[医药卫生—护理学]