老年急性心肌梗死患者PCI术后跌倒心理体验的质性研究

Psychological experience of falling in elderly patients with acute myocardial infarction after PCI: a qualitative study

目的:探讨老年急性心肌梗死(AMI)患者在PCI术后与跌倒相关的心理体验。方法:采用描述性质性研究方法,以最大差异抽样法选取2021年4—8月合肥市第二人民医院15例老年AMI行PCI治疗的患者进行半结构式访谈,使用Colaizzi七步分析法分析资料。结果:老年AMI患者行PCI术后的跌倒相关心理体验可归纳为3个主题:跌倒风险感知异常(跌倒风险感知不足、跌倒风险感知强化);跌倒负性情绪困扰(对跌倒事件的恐惧心理、对跌倒结局的预感性悲伤);对居家环境安全及支持监督体系的需求(需要安全的居家环境、依赖家人/医护人员的支持与监督、缺乏跌倒预防居家自我管理信息)。结论:老年AMI患者行PCI术后跌倒风险感知异常,对术后跌倒存在恐惧、悲伤等负性情绪,对居家心脏康复中环境安全及预防跌倒的支持监督体系有一定的需求。护理人员需为其制订个性化预警与干预措施,关注患者心理需求,促进患者角色适应,提供居家跌倒预防的延续性健康服务。

Objective To investigate the fall-related psychological experience of elderly patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A descriptive research method was used.A total of 15 elderly patients with AMI who received PCI in Hefei Second People′s Hospital from April 2021 to July 2021 were selected by the maximum difference sampling method for semi-structured interview.Colaizzi seven-step analysis method was used to analyze the data.Results The fall-related psychological experience of elderly AMI patients after PCI could be divided into three themes:abnormal perception of fall risk(insufficient perception of fall risk,enhanced perception of fall risk);negative emotional distress of falling(fear of falling,foreboding sadness of falling outcome);the need for a safe home environment and a supportive monitoring system(need a safe home environment,rely on family/health care staff for support and supervision,lack of self-management information on falling prevention at home).Conclusions Elderly patients with AMI have abnormal perception of risk of fall after PCI,and have negative emotions such as fear and sadness for postoperative fall.There is a certain demand for environmental safety and fall prevention support and supervision system in home cardiac rehabilitation.Nursing staff should formulate personalized early warning and intervention measures for them,pay attention to the psychological needs of patients,promote the role adaptation of patients,and provide continuous health services to prevent falls at home.