急性心肌梗死患者PCI术后戒烟后复吸烟动机的质性研究

Motivation of smoking after smoking cessation in patients with acute myocardial infarction after percutaneous coronary intervention: a qualitative study

目的了解急性心肌梗死患者PCI术后戒烟后复吸烟的真实想法,探索戒烟后复吸烟的动机,为护士指导其戒烟提供依据。方法2018年5—12月,采用目的抽样法选取青岛某三甲医院心内科收治的22例急性心肌梗死患者为研究对象,运用质性研究的现象学方法,对PCI术后患者戒烟后复吸烟动机进行深入访谈。用Colaizzi的现象学研究法和NVivo 12.0编码软件对资料进行分析、归纳。结果共得出9个主题,即戒烟动机4个主题(对疾病的担忧、对死亡的恐惧、需长期服药、家庭成员的影响),复吸烟动机5个主题(生活习惯的影响、疾病知识的缺乏、戒断症状、社会环境因素、工作压力大)。结论护士及护理管理者应关注急性心肌梗死患者PCI术后的心理需求,纠正其认知偏差,加大戒烟宣传力度等措施帮助患者戒烟,避免产生或减少其戒烟后复吸烟动机,从而提高戒烟成功率。

Objective To understand the true thoughts of patients to smoke again after smoking cessation post percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI), so as to provide guidance for the nurses to instruct the patients to cease smoking. Methods From May to December 2018, 22 patients with AMI admitted to the Department of Cardiology of a ClassⅢ Grade A hospital in Qingdao were selected as the participants in this study by purposive sampling. By the phenomenological method of qualitative research, in-depth interviews were conducted to the smoking patients who ceased smoking after PCI about their motivation. The data obtained were analyzed and summed up using the Colaizzi phenomenological research method and NVivo12.0 coding software. Results A total of 9 themes were concluded among which 4 themes were motivations of smoking cessation (concerns over the disease, fear on death, the needs of long-term medication, influences from family members), 5 themes were motivations of re-smoking (influences of life habits, lack of disease-related knowledge, symptoms from smoking cessation, social environment factors, strong work stress). Conclusions Nurses and nursing managers should pay more attention to the psychological needs in the AMI patients after PCI, so as to avoid or reduce their motivation of re-smoking by measures such as correcting their cognitive bias and intensify the publicity of smoking cessation, hence increase the successful rate of smoking cessation.