慢性阻塞性肺疾病患者呼吸困难恐惧体验及应对的质性研究

doi:10.3761/j.issn.0254-1769.2023.15.004

摘要/Abstract

摘要：

目的了解COPD患者呼吸困难恐惧的心理体验，并分析其应对行为。方法采用关键事件访谈法，对2022年6月—9月苏州市某三级甲等医院呼吸与危重症医学科收治的18例COPD患者进行深入访谈，通过内容分析法对访谈资料进行分析、归纳与提炼。结果归纳出3个主题，7个亚主题，包括呼吸困难恐惧的体验（呼吸困难恐惧影响日常生活、症状感知加重呼吸困难恐惧体验）、呼吸困难恐惧的应对（积极应对、消极回避）、缓解呼吸困难恐惧的支持需求（渴望得到专业支持、期盼获得家庭支持、亟需社会支持）。结论护理人员应当重视COPD患者呼吸困难恐惧的心理体验，通过接纳自我、降低症状感知以弱化其恐惧体验，改善认知、提高自我效能以促进其积极应对，加强专业人员、家庭、社会的多方支持以满足其呼吸困难恐惧缓解的多样化需求，改善患者的生活质量和不良结局。

关键词: 肺疾病, 慢性阻塞性, 呼吸困难恐惧, 回避行为, 支持需求, 质性研究, 护理

Abstract:

Objective This qualitative research aimed to explore the experiences of dyspnea-related fear among patients with COPD. Methods We performed in-depth interviews guided of behavioral-event-interview and analyzed the experiences of 18 inpatients who underwent dyspnea-related fear that came from a tertiary hospital in Suzhou from June to September 2022. Results 3 themes and 7 sub-themes were analyzed and summarized，including experiences of dyspnea-related fear（dyspnea-related fear affected daily routines，and symptoms perception exacerbated experiences of dyspnea-related fear），coping styles of dyspnea-related fear（positive coping and negative coping），support demands to alleviate dyspnea-related fear（eager to receive professional support，looking forward to family support，urgent demands for social support）. Conclusion Nursing staff should pay attention to patients’ experiences of dyspnea-related fear，weaken their fear experiences by accepting themselves and reducing their perception of dyspnea，promote positive coping by improving cognition and enhancing self-efficiency，meet the diverse demands to alleviate dyspnea-related fear by strengthening hospital-community-family support，ultimately improve their qualities of life and outcomes.

Key words: Pulmonary Disease, Chronic Obstructive, Dyspnea-Related Fear, Avoidance Behavior, Support Demands, Qualitative Research, Nursing Care

缪小浪, 钮美娥, 韩燕霞, 张蓓蕾, 赵茜, 卢向敏. 慢性阻塞性肺疾病患者呼吸困难恐惧体验及应对的质性研究[J]. 中华护理杂志, 2023, 58(15): 1815-1820.

MIAO Xiaolang, NIU Mei’e, HAN Yanxia, ZHANG Beilei, ZHAO Qian, LU Xiangmin. Experiences and coping styles of dyspnea-related fear among patients with chronic obstructive pulmonary disease：a qualitative research[J]. Chinese Journal of Nursing, 2023, 58(15): 1815-1820.

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