家属报告的耳聋患者人工耳蜗植入障碍与促进因素的质性研究

Qualitative research on barriers and facilitators of cochlear implantation in deafness patients reported by family members

目的了解家属报告的耳聋患者人工耳蜗植入(CI)障碍与促进因素,为制定干预方案提供依据。方法采用目的抽样法选取2022年3-8月安徽医科大学第一附属医院耳鼻咽喉头颈外科住院的11名耳聋患者家属为研究对象,采用半结构式访谈和Colaizzi现象学研究方法进行资料收集与分析。结果障碍因素提炼出6个主题:服务提供不完善、家属认知缺乏、手术/设备挑战、资金限制、时间冲突、其他障碍(心理压力大、文化水平低、缺乏家庭支持以及角色冲突等);促进因素提炼出4个主题:资源的可用性和可及性、耳聋危机感和治疗获益感、更好的经济背景和医保政策、良好的家庭文化氛围和亲属支持。结论家属报告的耳聋患者CI存在多重障碍,医护人员应制定针对性干预措施,给予认知、心理、社会等多方面支持,促使家属积极参与植入决策。

Objective To understand the families reported barriers and facilitators towards cochlear implant(CI)in deafness patients,so as to provide evidence for formulating intervention programs.Methods Purpose sampling was used to select 11 families of deaf patients who were hospitalized in the department of Otolaryngology Head and Neck Surgery of a tertiary hospital in Anhui province from March to August 2022 as the research objects,and semi-structured interviews and Colaizzi phenomenological research methods were used for data collection and analysis.Results The 6 themes of the obstacles were extracted:Inadequate service delivery,family's cognitive deficit,surgical/equipment challenges,financial constraints,time conflicts,and other barriers(high psychological stress,low literacy,lack of family support,role conflicts,etc.).The 4 themes of the facilitating factor included:the availability and accessibility of resources,the sense of crisis and benefit of treatment for deafness,better economic background and health insurance policies,good family culture and family support.Conclusion There are multiple obstacles to CI in deafness patients reported by families,and medical staff should formulate targeted intervention measures and provide cognitive,psychological,and social support to encourage families to actively participate in the implantation decision.