胰管结石患者内镜治疗体验及需求的质性研究

Qualitative study on the experience and demand of endoscopic treatment for patients with pancreatic duct stones

目的深入探究胰管结石患者在接受内镜治疗的感受及需求,为制定个性化方法提供依据。方法采用目的抽样法,选取2023年2-4月在上海市某三甲医院消化内科接受治疗的15例患者进行半结构式访谈,运用colaizzi 7步分析法对资料进行编码和总结,以提炼出主题。结果患者治疗体验及需求归纳为4个主题。①治疗前疼痛认知及应对管理不足:以持续性或间歇性腹痛为特征;起病位置隐匿,易被误诊;应对方式无效;影响日常生活,降低生活质量。②诊治期生理舒适度的改变:腹部软组织损伤;术后并发症。③治疗后态度发生改变:诊治前期待治疗;未达到预期时失落与怀疑;症状改善后坚定信念;④治疗期间的需求:专业人员的指导;延续性护理支持。结论胰管结石患者在内镜治疗前对疼痛认知不足,治疗过程中态度可能转变,并寻求外部支持。医护人员需关注其生理、心理及社会需求的动态变化,采取相应措施减轻疼痛,提升舒适度,促进患者康复。

Objective To explore the feelings and needs of patients with pancreatic duct stones undergoing endoscopic treatment,and to provide a basis for formulating personalized methods.Methods Purposive sampling method was used to select 15 patients who were treated in the Department of Gastroenterology of a ClassⅢGrade A hospital in Shanghai from February to April 2023 for semi-structured interviews.Colaizzi 7-step analysis method was used to code and summarize the data to refine the theme.Results The treatment experience and needs of patients were summarized into four themes.①Inadequate pain cognition and coping management before treatment:characterized by persistent or intermittent abdominal pain;The location of onset is hidden and easy to be misdiagnosed.Ineffective coping style;Affecting daily life and reducing the quality of life.②Changes of physiological comfort during the diagnosis and treatment period:abdominal soft tissue injury;Postoperative complications.③Attitude changes after treatment:expectant treatment before diagnosis and treatment;Disappointment and doubt when expectations are not met;Belief after symptom improvement;④Needs during treatment:professional guidance;Continuous nursing support.Conclusion Patients with pancreatic duct stones have insufficient knowledge of pain before endoscopic treatment.During the treatment,their attitudes may change and they may seek external support.Medical staff should pay attention to the dynamic changes of their physiological,psychological and social needs,and take corresponding measures to reduce pain,improve comfort and promote rehabilitation of patients.