脑卒中患者神经源性肠道功能障碍自我管理体验的质性研究

Self-management experience of neurogenic bowel dysfunction in stroke patients:a qualitative study

目的了解脑卒中患者神经源性肠道功能障碍的自我管理体验,为制订针对性护理干预措施提供参考。方法采用现象学研究方法,对14例住院脑卒中神经源性肠道功能障碍患者进行半结构式访谈,应用Colaizzi 7步分析法分析访谈资料。结果提炼出3个主题9个亚主题,即自我管理动力不足(神经源性肠道功能障碍认知不足、内驱力不足、反馈激励不足)、自我管理困扰体验(习惯固化、机体功能受损、用药困扰)、自我管理适应与调节(依赖药物、积极生活方式调整、应急行为调适)。结论脑卒中患者神经源性肠道功能障碍自我管理动力不足、困扰较多,医护人员应加强相关知识普及和专科指导,多途径提高患者自我管理意识和能力。

Objective To understand the self-management experience of neurogenic bowel dysfunction in stroke patients,and to provide a reference for developing targeted nursing intervention.Methods Using the phenomenological research method,a total of 14 stroke inpatients with neurogenic bowel dysfunction received semi-structured interviews,and the interview data were analyzed by using Colaizzi 7-step analysis method.Results A total of 3 themes and 9 sub-themes were extracted:lack of motivation for self-management(insufficient cognition of neurogenic bowel dysfunction,insufficient internal drive,lack of feedback and motivation),the troubled experience of self-management(habituation,impaired body function,drug use distress),self-management adjustment and regulation(drug dependence,lifestyle adjustment,emergency behavior adjustment).Conclusion The self-management motivation of neurogenic bowel dysfunction in stroke patients is insufficient,while some problems exist.Medical staff should strengthen the popularization of relevant knowledge and professional guidance,and improve patients′awareness and ability of self-management through multiple channels.