经皮冠状动脉介入治疗术后患者健康行为决策体验与需求的质性研究

doi:10.3761/j.issn.0254-1769.2024.15.008

摘要/Abstract

摘要：

目的探讨经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）术后患者进行健康行为决策时的体验和需求，为制订针对性的决策支持策略提供依据。方法基于渥太华决策支持框架，采用描述性质性研究方法，于2022年7月—12月，采用目的抽样法，在哈尔滨市某三级甲等综合医院选取16例PCI术后1年仍存在不健康行为的患者作为研究对象，采用半结构式访谈对其决策体验与需求进行深度访谈，以内容分析法对资料进行整理分析。结果共提炼出2个主题，6个亚主题，包括健康行为决策体验（健康行为获益的不确定感、健康行为低认同感、担忧行为改变的负性影响）；健康行为决策需求（健康行为知识的需求、医疗资源的需求、情感支持的需求）。结论 PCI术后患者较低水平的健康行为与其健康行为决策过程中的多种冲突体验和需求有关。临床护理人员应从患者的体验和需求出发，重视并及早识别患者的冲突体验，从知识、医疗资源、情感支持等方面满足患者个性化需求，促进其健康行为的转变和长久维持。

关键词: 经皮冠状动脉介入治疗, 健康行为, 决策, 质性研究, 护理

Abstract:

Objective To explore the experiences and needs of patients making health behavior decisions after percutaneous coronary intervention（PCI），and to provide evidence for formulating targeted decision support strategies. Methods Based on the Ottawa decision support framework and descriptive qualitative study，16 patients with unhealthy behaviors 1 year after PCI were selected as research subjects in a tertiary A general hospital in Harbin from July to December 2022 by purpose sampling method，and their decisional experience and needs were deeply interviewed by semi-structured interview method. The data were sorted out and analyzed by content analysis method. Results After the analysis of the interview data，the 2 themes and 6 sub-themes were extracted，including the experience of health behavior decision（uncertainty about the benefits of health behavior，low recognition of health behavior，and worry about the negative impact of behavior change）；health behavior decision-making needs （health behavior knowledge needs，medical resources needs，emotional support needs）. Conclusion PCI patients have a variety of conflicting experiences and multi-dimensional health behavior decision-making needs. Clinical nurses should start from the experience and needs of patients，pay attention to and identify the conflict experience of patients early，meet the individual needs of patients from the aspects of knowledge，medical resources，emotional support，etc.，and promote the transformation and long-term maintenance of PCI patients’ health behaviors.

Key words: Percutaneous Coronary Intervention, Health Behavior, Decision-Making, Qualitative Research, Nursing Care

张岚, 高学琴, 林平, 赵振娟, 刘国杰. 经皮冠状动脉介入治疗术后患者健康行为决策体验与需求的质性研究[J]. 中华护理杂志, 2024, 59(15): 1847-1851.

ZHANG Lan, GAO Xueqin, LIN Ping, ZHAO Zhenjuan, LIU Guojie. Health behavior decision-making experience and needs of patients after percutaneous coronary intervention：a qualitative research[J]. Chinese Journal of Nursing, 2024, 59(15): 1847-1851.

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