妇科术后尿瘘患者症状体验及心理感受的质性研究

Symptoms and psychological experience of patients with postoperative urinary fistula in gynecology:a qualitative research

目的探讨妇科术后尿瘘患者治疗及观察期的症状体验和心理感受,为护理人员给患者提供全方位护理措施,提高患者生活质量提供依据。方法采用现象学研究法,对12例妇科术后尿瘘患者进行半结构式访谈。结果归纳出4个主题,生理层面:排尿方式改变、活动受限、睡眠障碍、感染风险增加;心理层面:自我否定、病耻感;家庭层面:增加照护人员负担、性生活欲望降低;社会层面:社会融入感降低、个人成就感降低。结论妇科术后尿瘘患者术后面临生活、心理、经济等多重压力,医护人员应及时发现患者面临的问题,从有效沟通、人文关怀、健康教育、术后随访等多方面减少患者的不良疾病体验,提升患者生活质量。

Objective To explore the symptom experience and psychological feeling of patients with urinary fistula after gynecological surgery during treatment and observation period,so as to provide a basis for nurses to provide all-round nursing measures and high quality of life for patients.Methods The phenomenological method was used to conduct a semi-structured interview in 12 patients with postoperative urinary fistula.Results 4 themes were extracted,including the physiological aspect(Changes in urination patterns,decreased activity,sleep disturbances,increased risk of infection);the psychological aspect(Self-denial,stigma);the family aspect(Increase the burden on caregivers,reduced sexual desire);the society aspect(Reduced sense of integration and personal achievement).Conclusion Patients with urinary fistula after gynecological surgery face multiple pressures in physical,psychology and economy.Medical staff should find out the problems that patients are facing in order to reduce patients′negative disease experience and improve patients′quality of life from many aspects such as effective communication,humanistic care,health education and postoperative follow-up.