脊髓损伤神经源性膀胱患者间歇导尿心理体验的质性研究

A qualitative study on psychological experience of patients with neurogenic bladder in spinal cord injury undergoing intermittent catheterization

目的 探讨脊髓损伤神经源性膀胱患者行间歇导尿时的心理体验,为更好地实施膀胱功能训练提供依据.方法 采用质性研究中的现象学研究方法,对2016年7—10月在北京市某医院骨科收治的脊髓损伤神经源性膀胱患者12例进行深入访谈,分析患者导尿过程中的体验与感受.结果 患者的体验以及诉求集中在3个主题：患者对间歇导尿有排斥与厌恶、恐惧与愤怒、抑郁与孤独、接受与习惯化几种不同类型心理反应;间歇导尿效果不同时感受也不同,既有失败的沮丧也有成功的欣慰;期望建立完善的医护、家庭、社会应对支持机制.结论 患者对间歇导尿的心理体验有变化的过程,面对导尿成功与失败会表现出不同的心理感受,医护人员应为患者提供相关知识的健康宣教、技术指导,并给予心理疏导,理解并尊重患者的情感需求,构建合理的支持系统,提高患者依从性.

ObjectiveTo explore the psychological experience of patients with neurogenic bladder in spinal cord injury undergoing intermittent catheterization and provide references for better implementation of bladder function training.Methods Using the phenomenological method of qualitative research, 12 patients with neurogenic bladder in spinal cord injury in orthopedic department of one hospital in Beijing from July 2016 to October 2016 were surveyed by in-depth interviews. Experience and feelings of patients in the process of catheterization were analyzed.Results Experience and demands were mainly divided into three themes. First, patients undergoing intermittent catheterization had different types of psychological reactions including exclusion and disgust, fear and anger, depression and loneliness, acceptance and customization. Second, different intermittent catheterization effects resulted in different feelings including frustration and happy due to failing and success. Third, patients had expectation of establishing a perfect medical system and coping with support mechanisms of family and society.Conclusions Psychological experience of patients has a process of changing. They behave different psychological feelings with failing or success of catheterization. The doctors and nurses should provide health education and technical guidance as well as psychological counseling for the patients, understand and respect their emotional needs,establish appropriate supporting system and improve their compliance.