胰十二指肠切除术后患者对留置胃管期间舒适体验的质性研究

Qualitative study of the comfort experience of patients after pancreaticoduodenectomy during indwelling gastric tube

目的探讨胰十二指肠切除术后胃瘫患者留置胃管期间不良舒适体验的主要来源及其护理对策。方法选取2014年1月至2016年12月我院普外科接受胰十二指肠切除术且术后发生胃瘫综合征留置胃管患者32例作为研究对象,对32例胰十二指肠切除术后胃瘫患者采用半结构式访谈,并进行资料分析,提炼和总结主题,并探讨其护理对策。结果本研究提炼出的主题为:因胃管存在导致的心理不适28例,占87. 50%;由胃管导致的局部刺激症状32例,占100. 00%;难以正常进食导致的营养不良性乏力10例,占31. 25%;与护理措施有关的紧张、焦虑和不适感24例,占75. 0%;术后及留置胃管所致的躯体痛苦32例,占100. 00%;安全感缺失22例,占68. 75%。结论胰十二指肠切除术后发生胃瘫患者对留置胃管期间舒适体验的质性研究能够提炼出影响患者舒适性体验的主题,同时对于制定针对性的护理措施具有较高的指导意义,从而能够有效提高患者舒适感,改善生活质量,促进术后恢复。

Objective To explore the main sources of poor comfort experience of patients with gastroparesis after pancreaticoduodenectomy during indwelling gastric tube and the nursing strategies.Methods A total of 32 patients who received pancreaticoduodenectomy and had postoperative gastroparesis indwelling gastric tube in the general surgery department of our hospital from January 2014 to December 2016 were selected as the study subjects.These 32 patients with postoperative gastroparesis were treated with semi-structured interviews,and the data analysis was performed to refine and summarize the themes,thus exploring the nursing strategies.Results The theme extracted in this study were as follows: there were 28 cases showed psychological discomfort due to gastric tube,accounting for 87.50%;there were 32 cases showed local irritation due to gastric tube,accounting for 100.00%;there were 10 cases displayed malnutrition fatigue caused by difficulty in eating normally,accounting for 31.25%;a total of 24 cases had tension,anxiety and discomfort related to nursing measures,accounting for 75.0%;a total of 32 cases had physical pain caused by postoperative and indwelling gastric tube,accounting for 100.00%;a total of 22 cases showed loss of security,accounting for 68.75%.Conclusion The qualitative study of the comfort experience of patients with gastroparesis after pancreaticoduodenectomy for indwelling gastric tube can extract the theme that affects the patient's comfort experience.At the same time,it has a high guiding significance for the development of targeted nursing measures.Therefore,it can improve patient comfort and quality of life effectively,as well as promote postoperative recovery.