妇科腹腔镜术后患者恶心呕吐症状认知与积极应对的质性研究

A qualitative study on the cognition and positive coping of nausea and vomiting symptoms in patients after gynecological laparoscopic surgery

目的:术后恶心呕吐是妇科腹腔镜手术常见并发症,阻碍了舒适护理和快速康复外科的发展进程。探讨妇科腹腔镜术后患者恶心呕吐症状认知及积极应对体验,为构建干预方案提供借鉴,加快舒适护理和加速康复外科的发展进程。方法:该研究为描述性现象学研究,采用目的抽样法,选取2023年2~4月在桂林医学院第二附属医院就诊的16例妇科腹腔镜术后恶心呕吐患者作为研究对象,进行半结构式深入访谈,采用Colaizzi 7步分析法归纳提炼主题。结果:归纳出4个主题(5个亚主题),包括恶心呕吐相关知识认知不足(缺乏系统的了解途径、缺乏影响因素相关知识、缺乏足够的重视)、恶心呕吐的症状体验(主要为迷走神经相关的症状,伴有循环系统的症状)、对患者情绪和社会交往造成程度不一的不良影响、多模式的应对方式(自我应对方式和专业支持)。结论:患者的症状认知和体验各不相同,自我应对策略依从性不佳,应规范健康宣教体系,建立有效的积极应对策略,以改善患者的心理状态,提高患者的就医体验。

Objective:Postoperative nausea and vomiting is a common complication of gynecological laparoscopy,which hinders the development of comfortable nursing and rapid rehabilitation surgery.This study aims to explore the cognition and positive coping experiences of nausea and vomiting symptoms in patients after gynecological laparoscopic surgery,providing references for developing intervention programs and advancing the progress of comfort care and accelerated surgical recovery.Methods:This descriptive phenomenological study used purposive sampling to select 16 patients who experienced nausea and vomiting after gynecological laparoscopic surgery at the Second Affiliated Hospital of Guilin Medical University from February to April 2023.Semi-structured in-depth interviews were conducted,and the Colaizzi 7-step analysis method was used to summarize and extract themes.Results:A total of 4 themes(5 sub-themes)were identified:insufficient knowledge about nausea and vomiting(lack of systematic understanding,lack of relevant knowledge about influencing factors,and lack of adequate attention),symptoms experience of nausea and vomiting(mainly vagus nerve-related symptoms accompanied by circulatory system symptoms),varying degrees of adverse effects on patients’emotions and social interactions,and multi-modal coping styles(self-coping styles and professional support).Conclusion:Patients have different cognitions and experiences of symptoms,and adherence to self-coping strategies is poor.There is a need to standardize health education systems and establish effective positive coping strategies to improve patients’psychological states and enhance their medical experiences.