肺移植受者居家肺康复锻炼促进与障碍因素的质性研究

doi:10.3761/j.issn.0254-1769.2024.17.003

摘要/Abstract

摘要：

目的探究肺移植受者居家肺康复锻炼的促进与障碍因素，为构建精准化的居家肺康复干预提供参考依据。方法采取目的抽样法，于2023年8月—11月对20例肺移植受者进行半结构式访谈，基于能力-机会-动机-行为模型，运用传统内容分析法进行资料分析。结果肺移植受者居家肺康复的促进因素主要包括机会因素（移植中心的康复管理、多元化的社会支持）、动机因素（康复益处感知、高水平康复自我效能、较强的康复动机、强烈的责任感和良好的运动习惯）；障碍因素包括能力因素（身体功能障碍、康复知识缺乏）、机会因素（不利的康复环境、沉重的经济负担）、动机因素（运动恐惧、不适的运动体验和缺乏康复自律性）。结论肺移植受者居家肺康复锻炼受到多种因素的影响，临床医护人员应采取针对性策略促进肺移植受者开展居家肺康复，以期提高受者的运动能力和生活质量，改善其临床结局。

关键词: 肺移植, 居家, 肺康复, 影响因素分析, 能力-机会-动机-行为模型, 质性研究, 康复护理

Abstract:

Objective To explore the influencing factors of home pulmonary rehabilitation for lung transplant recipients，so as to provide a basis for the construction of targeted intervention for home rehabilitation. Methods From August to November 2023，the purposive sampling was used to select 20 cases of lung transplant recipients for semi-structured interviews. Data was analyzed by traditional content analysis method based on capability，opportunity，and motivation-behavior model. Results Facilitators of rehabilitation behavior included opportunity factors（rehabilitation management of transplant center，multiple social support），motivational factors（perceived benefits，high self-efficacy，strong motivation，strong sense of responsibility，and good exercise habits）. Barriers of rehabilitation behavior included ability factors（physical dysfunction，lack of knowledge），opportunity factors（poor rehabilitation environment，heavy economic burden），motivational factors（fear of exercise，uncomfortable activity experience，and lack of rehabilitation self-discipline）. Conclusion The influencing factors of home pulmonary rehabilitation in lung transplant recipients are complex. Medical staff should take targeted measures to promote home rehabilitation to improve the exercise ability，quality of life，and clinical outcomes.

Key words: Lung Transplantation, Home, Pulmonary Rehabilitation, Root Cause Analysis, Capability, Opportunity, and Motivation-Behavior Model, Qualitative Research, Rehabilitation Nursing

胡树菁, 孙菁, 王奕, 高宝, 朱虹, 齐星宇. 肺移植受者居家肺康复锻炼促进与障碍因素的质性研究[J]. 中华护理杂志, 2024, 59(17): 2070-2076.

HU Shujing, SUN Jing, WANG Yi, GAO Bao, ZHU Hong, QI Xingyu. Facilitators and barriers of home pulmonary rehabilitation for lung transplant recipients：a qualitative study[J]. Chinese Journal of Nursing, 2024, 59(17): 2070-2076.

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