腹壁成形术患者决策体验的质性研究

Decision-making experience of patients with abdominoplasty:a qualitative study

目的探索我国产后腹壁松弛患者腹壁成形术决策过程的体验。方法选取2023年6至8月在华中科技大学同济医学院附属协和医院就诊的产后腹壁松弛患者进行半结构式访谈。运用Clolaizzi 7步分析法对资料进行整理分析,并进行主题描述。结果共纳入15例患者,年龄29~53岁;大专及以上11人,大专以下4人;已婚13人,离异2人。依据访谈资料共提炼出4个主题:(1)负性的感知体验;(2)决策困境;(3)同伴支持;(4)医生主导的决策模式。通过访谈可知,产后腹壁松弛患者面临的主要决策困境是缺乏信息和家庭支持,获得的支持多来自于病友间的信息交流,其对手术相关知识、改善程度、风险等认知不足,临床决策参入程度较低。结论我国产后腹壁松弛患者对腹壁成形术存在迫切的心理需求,但有多种因素对患者决策体验产生不良影响。

Objective To explore the decision-making experience of patients undergoing abdominoplasty in our country.Methods A semi-structured interview was conducted with patients suffering from postpartum abdominal wall laxity who were treated at Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from June to August 2023.The data were sort and analyzed using the Clolaizzi 7-step analysis method for thematic description.Results A total of 15 patients,aged 29-53 years,were included in the study.11 had a college education or higher,while 4 had less than a college education.Thirteen were married and two were divorced.According to the interview data,four themes were extracted:(1)negative perceptual experiences;(2)decision-making dilemmas;(3)peer support;(4)a physician-led decision-making model.According to the interview,the main decision-making dilemma faced by patients with postpartum abdominal wall laxity was lack of information and family support,and the support they get was mostly from information exchange among patients,and they had insufficient cognition of surgical knowledge,improvement degree and risk,and low participation in clinical decision making.Conclusion Patients with postpartum abdominal wall laxity in China have an urgent psychological need for abdominoplasty,but there are many factors that have adverse effects on their decision-making experience.