喉癌患者健康行为改变障碍的质性研究

Barriers to health behavior change in patients with laryngeal cancer:aqualitative study

目的了解喉癌手术患者出院后健康行为改变存在的障碍,为临床干预提供参考。方法采用质性研究中的现象学研究方法对14例喉癌患者进行深入访谈,分析资料及提炼主题。结果喉癌患者所理解的健康行为包括戒烟、避免酗酒、合理饮食、体育锻炼、控制体质量、术后嗓音锻炼、情绪管理、戴管形象维护、主动寻求治疗、放疗后皮肤护理、药物治疗11种;提炼出治疗不良反应干扰-生理性障碍、不良情绪干扰-心理社会性障碍、外界因素干扰-其他障碍3个主题。结论喉癌患者出院后的健康行为改变存在多重障碍,医护人员应制定针对性健康促进干预计划,完善医疗团队支持体系,给予患者多方面的支持,将障碍因素转化为改善健康行为的动力。

Objective To describe barriers to health behavior change after discharge in patients with laryngeal cancer treated surgically and to provide reference for future clinical intervention.Methods Fourteen patients with laryngeal cancer were interviewed by using phenomenological research method,and data were used to identify themes.Results In patients′opinion,the health behaviors included smoking cessation,avoiding alcohol use,healthful diet,regular physical activity,weight control,postoperative voice training,emotion management,body image maintenance with indwelling tube,seeking professional medical attention,skin care after radiotherapy,and medication therapy.Three themes were identified including physiological disorder related to side-effects of treatment,psychosocial disorder related to negative feelings,and other disorder related to environmental interference.Conclusion There are multiple barriers to health behavior change in patients with laryngeal cancer after discharge.Medical personnel should formulate targeted health promotion strategies,improve medical support system,and strengthen comprehensive support for patients,thus to overcome the barriers to health behavior change.