慢性乙型肝炎患者角色适应障碍的定性研究

Qualitative Study of Role Adaptation Disorders in Patients with Chronic Hepatitis B

目的了解慢性乙肝患者的角色适应状况及存在的问题,探讨慢性乙肝患者病人角色适应障碍的主要影响因素。方法运用方便抽样方法,通过对94例慢性乙肝患者进行一对一半结构式访谈,整理分析访谈资料,探索慢性乙肝患者角色适应过程中的角色强化、角色消退及角色冲突的心理特征和行为表现。结果受访的94例慢性乙肝患者中有82(87.2%)人存在不同程度的角色适应障碍,其中60.6%的受访者具有病人角色强化的行为和心理特征;66.0%的受访者存在病人角色冲突状况;12.8%的受访者表现出病人角色消退。影响患者病人角色适应的主要因素有性别、婚育状况、家庭支持、疾病认知、社会歧视、自我歧视和家族遗传史。结论慢性乙肝患者角色适应障碍的状况较为普遍,且其影响因素间相互联系、共同作用,建议从乙肝患者、医护人员、社会环境与家庭支持多角度帮助该人群实现良好的角色适应。

Objective To explore role adaptation experience,potential problems as well as influential factors of role adaptation disorders among chronic hepatitis B(CHB)patients.Methods One-on-one semi-structured interviews were conducted in a convenience sample of 94 CHB patients.Psychological and behavioral characteristics of CHB patients on role reinforcement,role regression and role conflict during the process of role adaptation were analyzed.Results 87.2%CHB patients in this study reported different levels of role adaptation disorders.Three fifths of them had role reinforcement in psychological and behavioral aspects,about 66.0%of them had role conflicts,and 12.8%CHB patients showed role regression.The main influential factors included gender,marital and parental status,family support,disease cognition,social discrimination,self-discrimination and family history of the di-sease.Conclusion Role adaptation disorders among CHB patients is prevalent,and the influential factors interrelate and act together.Our results suggested that multiple countermeasures should be taken to help CHB patients adapt their multiple roles,not only from patients themselves but also from their families,healthcare staff and the social environment.