老年泌尿造口患者出院准备困境的质性研究

Readiness for hospital discharge in older patients with urostomy:the patient′s predicament

目的探讨老年泌尿造口患者出院准备过程中的困境,为患者过渡期的出院准备护理提供参考。方法目的抽样选取膀胱癌行根治性膀胱切除术+泌尿造口术的16例老年患者进行半结构式访谈,采用Colaizzi 7步分析法提炼主题。结果提炼出自我感知体验困境(出院决策困境,症状管理困境,造口自护技能困境,日常生活困境,负性心理困境,角色适应困境)和支持系统困境(家庭支持困境,医疗支持困境,社会支持困境)2个主题及9个亚主题。结论老年泌尿造口患者面临诸多出院准备困境,医护人员应全面评估,并实施针对性干预,以降低患者出院准备困境,使之顺利回归家庭与社会。

Objective To explore the predicament during the course of discharge preparation in older patients with urostomy,and to provide reference for nursing process of discharge.Methods A purposive sample of 16 patients who underwent radical cystectomy with urinary diversion for bladder cancer participated in this study.Semi-structured interviews were conducted and the Colaizzi′s seven-step method of phenomenological analysis was used to extract themes.Results Two themes and nine sub-themes emerged:the self-perceived experiential predicament(discharge decision-making,symptom management,ostomy self-care skills,daily life,negative moods,and role adaptation)and the support system predicament(family support,medical support,and social support).Conclusion Older patients with urostomy face various predicaments in the course of discharge preparation.Healthcare professionals should conduct comprehensive assessments and implement targeted interventions to reduce these predicaments,enabling patients to smoothly return to their families and society.