妇科腹腔镜手术后早期下床活动影响因素的质性研究

Qualitative study on influencing factors of early getting out of bed after gynecological laparoscopic surgery

目的探讨妇科腹腔镜手术后早期下床活动的影响因素。方法选取2021年1月至2月南京鼓楼医院妇科腹腔镜手术后的16例患者为研究对象,进行半结构式、面对面深度访谈,录音并观察研究对象,借助Nvivo12Plus软件,根据Colaizzi分析法对资料进行分析整理并提炼主题,在访谈16例患者后,资料达到饱和,结束资料收集工作。结果根据对资料分析整理提炼得到4个主题:腹部伤口疼痛、盆腔内脏疼痛、两侧肋骨疼痛、肩部疼痛、腹部胀痛、引流管牵拉痛、留置尿管尿道胀痛;术前禁食禁水时间长、术后进食少、术后呕吐、睡眠不足导致术后疲乏;留置引流管、尿管、输液导致行动不便;对于术后早期下床活动认知不足。结论针对患者早期下床活动的影响因素,医护人员可以采取多种方法预防或缓解术后疼痛、术后疲乏,加强健康宣教、家庭支持从而促进患者早期下床活动。

Objective To investigate the influencing factors of early getting out of bed after gynecological laparoscopic surgery.Methods A total of 16 patients after gynecological laparoscopic surgery in Nanjing Drum Tower Hospital from January to February 2021 were selected as the study objects.A semi-structured face-to-face in-depth interview was conducted,and the research objects were recorded and observed.With the help of Nvivo12Plus software,the data was analyzed and refined according to the Colaizzi analysis method.After interviewing 16 patients,the data reached saturation,and the data collection was finished.Results According to the analysis of the data,four themes were obtained:abdominal wound pain,pelvic viscera pain,bilateral ribs pain,shoulder pain,abdominal distengding pain,drainage tube dragging pain,urethral pain caused by indwelling catheter;Long time of fasting and water deprivation before operation,less food intake after operation,postoperative vomiting and lack of sleep lead to postoperative fatigue;Indwelling drainage tube,urinary catheter and infusion leads to mobility inconvenience;Insufficient knowledge of getting out of bed early after operation.Conclusion According to the influencing factors of patients'early getting out of bed,medical staff can take a variety of methods to prevent or relieve postoperative pain and fatigue,strengthen health education and family support to promote patients'early getting out of bed.