老年急性心肌梗死PCI术后患者健康促进行为驱动力的质性研究

Qualitative research on the driving force of health promotion behavior in elderly patients with acute myocardial infarction after PCI

目的探讨老年急性心肌梗死(AMI)PCI术后患者出院后健康促进行为的驱动因素,为改善患者的健康行为提供依据。方法本研究采用质性研究中的现象学研究法。采用目的抽样法,选取2019年11月—2020年1月在广州某三级甲等医院AMI门诊复诊的12例老年AMI行PCI术后患者为研究对象。采用半结构访谈法对其进行深度访谈,并采用Colaizzi 7步分析法分析资料。结果共提炼2个主题:(1)内源性驱动力,包括积极的自我感知老化、家庭责任感知、对未来社会发展的期待、健康相关控制感4个亚主题;(2)外源性驱动力,包括社会支持系统、自然与社会医疗环境、长期的医疗经济费用3个亚主题。结论老年AMI行PCI术后患者健康促进行为的驱动力复杂多样,医护人员应根据老年患者的个性化特征,调动患者的内源性与外源性驱动力,促使其采取健康促进行为,养成良好的健康生活方式。

Objective To explore the driving factors of health promotion behavior in elderly patients with acute myocardial infarction(AMI)who underwent percutaneous coronary intervention(PCI)after discharge,and to provide a basis for improving the health behavior of patients.Methods This research adopted the method of phenomenological research in qualitative research.From November 2019 to January 2020,purpose sampling was used to select 12 elderly patients with AMI who underwent PCI after follow-up visits in the AMI Outpatient Clinic of a ClassⅢGrade A hospital in Guangzhou as the research objects.Semi-structured interview was used to conduct in-depth interviews with patients.The data was analyzed using the Colaizzi 7-step analysis method.Results A total of two themes were refined:(1)endogenous driving forces,including four sub-themes of positive self-perception of aging,family responsibility perception,expectations for future social development,and health-related sense of control;(2)exogenous driving force,including three sub-themes of social support system,natural and social medical environment,and long-term medical economic costs.Conclusions The driving forces for health promotion behaviors in elderly patients undergoing AMI after PCI are complex and diverse.Medical and nursing staff should mobilize the endogenous and exogenous driving forces of the patients according to the individual characteristics of elderly patients,urge them to adopt health promotion behaviors and develop a good healthy lifestyle.