脑卒中患者跌倒恐惧心理体验的质性研究

Qualitative Research on the Psychological Experience of Stroke Patients’ Fear of Falling

目的:深入了解脑卒中患者跌倒恐惧的心理体验,为临床护士实施针对性护理干预措施提供参考依据。方法:2022年6月至2022年10月,采用目的抽样法选取贵阳市某三级甲等综合性医院入住神经内科脑卒中跌倒的患者,对研究对象进行一对一半结构式访谈,采用Colaizzi 7步分析法进行资料分析。结果:脑卒中患者跌倒恐惧心理的体验共提炼3个主题:对跌倒恐惧的负性体验(恐惧、心理负担过重、担心再次跌倒),对跌倒恐惧的正性体验(提高自我管理意识、提高跌倒警觉度),对跌倒恐惧应对策略的需求(知识需求、照顾需求、外界支持需求)。结论:跌倒恐惧相关心理问题普遍存在于脑卒中患者中,针对脑卒中患者跌倒恐惧心理,应及时正确评估脑卒中患者跌倒恐惧的负性体验并实施有效干预策略减轻患者过度恐惧,加强健康宣教,提高患者对跌倒警觉度,减少意外事件的发生,促进外界支持环境的形成,满足患者多方面的需求。

Objective: To gain an in-depth understanding of the psychological experience of stroke patients’ fear of falling and to provide a reference basis for clinical nurses to implement targeted nursing interventions. Methods: From June 2022 to October 2022, patients admitted to a tertiary care general hospital in Guiyang City with stroke falls were selected using a purposive sampling method, a one-to-half structured inter-view was conducted with the study participants, and the data were analysed using the Colaizzi 7-step analysis method. Results: Three themes were extracted from the experiences of stroke pa-tients’ fear of falling: negative experiences of fear of falling (fear, psychological overload, fear of fall-ing again), positive experiences of fear of falling (increased self-management awareness, increased fall alertness), and needs for coping strategies for fear of falling (knowledge needs, care needs, ex-ternal support needs). Conclusion: Psychological problems related to fear of falling are common in stroke patients. To address the psychological fear of falling in stroke patients, it is important to cor-rectly assess the negative experience of fear of falling in stroke patients and implement effective intervention strategies to alleviate excessive fear, strengthen health education, increase patients’ awareness of falling, reduce the occurrence of accidents, promote the formation of an external sup-portive environment, and meet patients’ multiple needs.