PTBD患者院外带管生活体验的质性研究

The quality of life of post-discharge patients carrying drainage tube after PTBD:a qualitative study

目的了解PTBD患者院外带管生活的真实体验,以便制定相对应的健康教育和延续性护理方案。方法应用质性研究的现象学方法,由介入专科责任护士对带管出院1个月以上的恶性梗阻性黄疸PTBD患者进行深入访谈,运用Colaizzi七步分析法进行资料的整理和分析。结果纳入本研究患者10例,PTBD患者院外带管生活体验的主要内容包括日常生活自理能力改变,患者角色强化或缺如;担心管道脱出、感染等问题;自我形象紊乱,社交恐惧;不同程度的身体不适及负性情绪和心理压力;希望引流袋及固定材质、方式等得到改进,希望能有更便利的换药的途径等。结论 PTBD患者的生活处于不同程度的应激状态,医护人员应开展针对性的健康教育和延续性护理,包括研究器材改进等以帮助其提高自护能力、降低并发症和心理压力,从而提高生活质量。

Objective To make a further recognition of the real quality of life of post-discharge patients who carry a percutaneous transhepatic biliary drainage（PTBD） tube due to malignant obstructive jaundice in order to formulate the corresponding scheme of health education and continued nursing. Methods By using qualitative research with phenomenological method, the interventional specialized nurse made a in-depth interview with the post-discharge patients who carried a PTBD tube due to malignant obstructive jaundice. Colaizzi seven-step analysis method was adopted to collate and analyze the clinical data. Results A total of 10 patients were finally enrolled in this study. The main considerations of patients carrying a PTBD tube in daily life included the changes of self-care ability in daily life, intensification or absence of a patient＇s role; worrying about prolapse and infection of the tube; disordered self-image and social phobia; different degrees of physical discomfort and negative emotion with psychological pressure;hoping improvement of the drainage bag and fixed materials and way; hoping more convenient way of dressing, etc. Conclusion The post-discharge patients carrying a PTBD tube live in different levels of stress.The medical staff should carry out targeted health education and extension care to help them and make research to improve equipment, so as to improve self-care ability, reduce complications as well as psychological pressure, thus, to improve the quality of life.