社区老年糖尿病患者自我忽视的诠释性现象学研究

Self-neglect in elderly diabetic patients in the community:an interpretive phenomenological study

目的探索社区老年糖尿病患者自我忽视的体验和原因,为社区护理人员识别和干预老年糖尿病患者自我忽视行为提供参考。方法采用诠释性现象学方法,通过目的抽样,2023年3月—5月,选取浙江省杭州市3个社区卫生服务中心登记的老年糖尿病患者进行半结构式访谈,采用Van Manen方法分析质性资料。结果社区老年糖尿病患者自我忽视的体验共归纳为4个主题和10个亚主题,包括忽视个人健康(自我价值感较低、自尊水平过高、担心拖累家庭),忽视血糖管理(健康意识薄弱、血糖管理困难),自我照护能力不足(经济状况不佳、个人时间有限、活动能力减弱)和支持感知不足(社会支持较低、情感支持不足)。结论社区老年糖尿病患者自我忽视的体验和原因是多元化的,社区卫生服务机构及护理人员需重视老年糖尿病患者自我忽视行为的表现,并积极探索有效的防治措施。

Objective To explore the experience and causes of self-neglect of elderly diabetic patients in community,so as to provide references for community nursing workers to identify and intervene the self-neglect behavior of elderly diabetic patients.Methods An interpretative phenomenological method was used to collect data from elderly diabetic patients registered in 3 community health service centers in Hangzhou,Zhejiang Province through semi-structured interviews.Van Manen’s method was used to analyze qualitative data.Results The experience and reasons of self-neglect of elderly diabetic patients in community were summarized into 4 themes and 10 sub-themes,including neglecting personal health(low sense of self-worth,high level of self-esteem,being afraid of compromising the family),neglecting blood glucose management(weak health awareness,difficulty in blood glucose management),inadequate self-care capacity(poor financial situation,insufficient personal time,diminished mobility)and inadequate perceived support(low social support,insufficient emotional support).Conclusion The experience and reasons of self-neglect of elderly diabetic patients in community are diversified.Community health services and nursing workers should pay attention to the performance of self-neglect behavior of elderly diabetic patients and actively explore effective prevention and intervention measures.