基于健康赋权理论访谈中青年腹膜透析患者回归社会的质性研究

An investigation based on health empowerment theory into middle-aged and young patients undergoing peritoneal dialysis

目的探讨基于健康赋权理论访谈中青年腹膜透析患者回归社会的质性研究情况,进而为制订促进腹膜透析患者回归社会工作的干预提供依据。方法采用目的抽样方法,选取11例在职中青年腹膜透析患者,采用基于健康赋权理论的访谈提纲对患者进行半结构式访谈,访谈结束后采用Colaizzi资料分析法将资料进行分析,并提取主题词。结果共提取9个主题词,(1)信念和态度方面包含患者回归社会工作受责任感驱动、经济负担驱使及社交需求被满足;(2)知识和能力方面包含回归社会工作能够维持正常腹膜透析,但缺乏解决相关并发症的能力,回归社会工作后劳动能力下降多,拥有部分完成工作的能力(3)行动和表现方面包含回归社会工作后职业自我发展受限;(4)支持和资源方面包含回归社会工作后获得较多社会支持,回归社会工作后需要专业的慢病管理指导,回归社会工作后希望能得到适当的社会福利保障。结论回归社会工作有利于改善中青年腹膜透析患者的生活状况,但是患者亦存在一定程度的经济困难、身体疲乏、疾病管理知识能力不足等困境。医务人员应给予提供专业自我疾病管理知识宣教,加强亲属外的社会支持体系,帮助中青年腹膜透析患者改善困境,有利于患者回归社会工作及提升其生活质量。

Objective To investigate the status quo of returning to the society of middle-aged and young patients undergoing peritoneal dialysis based on the health empowerment theory. Methods Using the purposive sampling method, 11 patients were interviewed. The interview results were analyzed using Colaizzi analysis and the keywords were extracted. Result A total of 9 keywords were extracted, including beliefs and attitudes（ the sense of responsibility, economic burden and social needs to be met）; knowledge and ability（ ability to maintain normal peritoneal dialysis but lack of the ability to solve related complications and decreased work ability after returning to society）; related to action and performanc（ limited occupational self-development after returning to society,related to social support and resources： more social support, guidance in chronic disease management and proper social welfare）. Conclusions Returning to society can improve the living conditions of middle-aged and youth patients with peritoneal dialysis although they can run into troubles in economic conditions, fatigue, and lack of disease management knowledge and ability. Medical workers should provide them with instructions on disease management knowledge, strengthen social support system other than their families and help them out of the troubles so that they can return to society and enhance their life of quality.