退变性脊柱侧凸患者术后延续性健康教育需求的质性研究

Qualitative study on postoperative continuing health education needs of patients with degenerative scoliosis after surgery

目的了解退变性脊柱侧凸患者术后的康复现状及现存问题,分析患者延续性健康教育的需求。方法采用便利抽样法,选取2021年12月—2022年6月在南京大学医学院附属鼓楼医院行手术治疗的15例处于康复期的退变性脊柱侧凸患者,通过半结构式访谈了解患者对手术效果的感受、对术后生活影响的体验、对康复锻炼的想法、对居家现状的自身认知、对未来发展的规划等。应用Colaizzi 7步分析法提取主题。结果归纳退变性脊柱侧凸患者术后延续性健康教育需求相关的4个主题,分别为:对腰背部或下肢的活动受限不能接受、对延续性康复锻炼存在盲区、缺乏脊柱术后疾病自我管理知识、对社会及心理支持有需求。结论退变性脊柱侧凸患者术后康复知识和技能,对健康教育需求强烈。医护人员可以通过教育患者适应现状、提供个体化康复目标、指导患者管理影响自身康复的危险因素、完善社会家庭支持系统等满足患者的延续性护理需求,从而促进患者快速康复。

Objective To understand the current rehabilitation status and existing problems of patients with degenerative scoliosis after surgery,and analyze the needs of continuous health education for patients.Methods A total of 15 patients with degenerative scoliosis undergoing surgical treatment in Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University from December 2021 to June 2022 were selected by the convenient sampling method.The semi-structured interview was used to understand the patient's feelings on the operation effect,experience on the postoperative life impact,thoughts on rehabilitation exercise,self-cognition of home status and future development planning.Based on the rooted theory,Colaizzi 7-step analysis was applied to extract the topic.Results The four themes related to the continuous health education needs of patients with degenerative scoliosis after surgery were summarized,which were unacceptable movement limitation of lower back or lower extremity,blind area of continuous rehabilitation exercise,lack of knowledge of self-management of spinal disease after surgery and need for social and psychological support.Conclusions Patients with degenerative scoliosis lack of postoperative rehabilitation knowledge and skills,and the need for health education is strong.Medical staff can meet the patients'transitional care needs by educating them to adapt to the current situation,providing personalized rehabilitation goals,guiding patients in managing risk factors that affect their own rehabilitation and improving social and family support systems,thereby promoting rapid recovery of patients.