气管袖状切除及端端吻合术后患者头低位管理障碍和促进因素的质性研究

Qualitative study on obstacle and promoting factors of head-down position management in patients after tracheal sleeve resection and end-to-end anastomosis surgery

目的调查气管袖状切除及端端吻合术后患者头低位管理的障碍和促进因素。方法采用目的抽样法,2023年11月至2024年1月对首都医科大学附属北京同仁医院耳鼻咽喉头颈外科符合纳排标准的8例气管袖状切除及端端吻合术后患者及5名护士进行半结构式访谈,采用Colaizzi现象学资料7步分析法进行资料整理与分析,提炼术后患者头低位管理的障碍和促进因素。结果障碍因素提炼出4个主题,即前期准备不充分、注意力不集中、情绪负担、环境及设备限制;促进因素提炼出3个主题,包括舒适的康复环境、家庭及社会支持、专业照护帮助。结论术后患者头低位管理依从存在诸多困难和挑战,提示医护人员应注意提供舒适环境及做好前期准备,重视患者情绪负担,为患者提供全面、个性化的身心照护。

Objective To investigate the obstacle and promoting factors of head-down position management in patients after tracheal sleeve resection and end-to-end anastomosis surgery.Methods A purposive sampling method was used to conduct semi-structured interview on eight patients with end-to-end anastomosis surgery and five nurses met inclusion and exclusion criteria at Department of Otolaryngology Head and Neck Surgery in Beijing Tongren Hospital of Capital Medical University from November 2023 to January 2024.Colaizzi phenomenological data seven-step analysis method was used to organize and analyze data.Obstacles and promoting factors of head-down position management in patients after surgery were extracted.Results Four themes were extracted from obstacle factors,namely inadequate preparation in the early stage,lack of concentration,emotional burden,and environmental and equipment limitations.Three themes were extracted from promoting factors,included comfortable rehabilitation environment,family and social support,and professional care assistance.Conclusion There are many difficulties and challenges on head-down position management compliance in patients after surgery.It is suggested that medical staff should pay attention to providing comfortable environment and making early preparations,paying attention to the emotional burden of patients,and providing comprehensive and personalized physical and mental care for patients.