基于扎根理论的消化道肿瘤患者就医行为决策模式的构建

Construction of a Decision-making Model for Medical-seeking Behavior of Patients with Gastrointestinal Tumors Based on Grounded Theory

目的:通过对消化道肿瘤患者就医行为问卷调查和访谈的质性分析,基于扎根理论构建患者就医行为决策模式,为引导患者科学就医提供理论参考。方法:于2022年7月—2023年2月对140例消化道肿瘤患者进行了就医行为问卷调查,并结构化访谈20名医护人员。应用质性研究分析工具NVivo11中文版软件,对调查问卷和访谈材料进行词频分析、节点编码等质性研究,并进行理论饱和度检验。结果:通过词频查询生成词云图和高频词统计表,对调查问卷和访谈资料进行三级节点编码,得到5个父节点、12个子节点,基于文献研究、扎根理论和决策理论,经过反复比较、分析和归类,提炼出时机选择、医院选择、治疗选择、应对选择和支付选择五个核心范畴,构建消化道肿瘤患者就医行为决策模式的理论框架。结论:消化道肿瘤患者就医行为决策模式的提出和对策建议,可以帮助患者回归理性就医、合理利用医疗资源,有效防治肿瘤、促进健康。

Objective:To qualitatively analyze the questionnaire and interview data of patients with gastrointestinal tumors seeking medical treatment,and construct a decision-making model for patients with gastrointestinal tumors based on grounded theory,so as to provide a theoretical reference for guiding patients to seek medical treatment scientifically.Methods:In this study,from July 2022 to February 2023,a questionnaire survey was conducted on 140 patients with gastrointestinal tumors,and 20 medical staff were inter-viewed in a structured manner.Using the qualitative research analysis tool NVivo11 Chinese version software,conduct qualitative re-search on questionnaires and interview materials such as word frequency analysis,node coding,and theoretical saturation testing.Re-sults:The word cloud map and statistical table of high frequency words was generated by word frequency query.Three-level node cod-ing was carried out on the questionnaire and interview data,and 5 parent nodes and 12 child nodes were obtained.Based on previous literature research,grounded theory and decision theory,after repeated comparisons,analyzes and classifications,The five core catego-ries of timing selection,hospital selection,treatment choice,coping choice and payment choice construct a theoretical framework for the decision-making model of medical treatment behavior of patients with gastrointestinal tumors.Conclusion:The decision-making model and countermeasures for patients with gastrointestinal tumors can help patients return to rational medical treatment behavior,ra-tionally use medical resources,choose appropriate and moderate medical and health services,effectively prevent and treat tumors,and promote health.