腹壁肿瘤扩大切除术后患者康复期症状体验和心理感受的质性研究

Symptoms and Psychological Experience of Patients after Extensive Abdominal Wall Tumor Resection:A Qualitative Research

目的探讨腹壁肿瘤扩大切除术后患者康复期症状体验和心理感受,使医护人员能全面掌控患者术后症状并进行管理,从而为促进患者术后康复提供依据。方法采用现象学研究法,对腹壁肿瘤扩大切除术后11例康复期患者进行半结构式访谈,利用Nvivo12 Plus软件整理访谈资料,并运用Colaizzi 7步分析法对原始资料进行分析。结果归纳出4个主题,身体不适:活动性疼痛、睡眠障碍、下肢麻木、手术部位皮肤紧绷感;营养失调:食欲不振、肠外营养不耐受、体质量下降;体力活动受限:卧床时间长、活动无耐力;担心疾病复发和住院费用:疾病复发的忧虑、经济压力的担忧。结论腹壁肿瘤扩大切除术后患者康复期面临多方面的困扰,医护人员在康复期应完善患者症状管理,改善患者的身体不适;量身定制营养支持方案,改善营养失调;制定康复计划,循序渐进的增加活动水平;有效疏导情绪,减轻心理压力。

Objective To explore the symptoms and psychological experience of patients after extensive abdominal wall tumor resection,so that medical staff can fully control and manage postoperative symptoms of patients,and to provide reference for promoting postoperative rehabilitation of patients.Methods Semi-structured interviews were performed in 11 patients after extensive abdominal wall tumor resection.Nvivo12 Plus and Colaizzi method were used to sort out and analyzed original data.Results Four themes were extracted,including physical discomfort(activity-related pain,somnipathy,numbness of lower limb,and skin tension at the surgical site);nutritional disorders(loss of appetite,intolerance of parenteral nutrition and weight loss);limited physical activity(long time in the bed and activity intolerance);and worry about recurrence of the disease and hospital cost(the fear of recurrence of the disease and the worry of economic pressure).Conclusion Patients after extensive abdominal wall tumor resection still face many problems during rehabilitation.The evaluation and intervention of patients’physical and mental health should be strengthened to improve their physical and mental health as well as quality of life.