中青年肠造口患者及其主要照护者护理依赖二元应对体验的质性研究

doi:10.3761/j.issn.0254-1769.2025.04.001

摘要/Abstract

摘要：

目的探讨家庭弹性视角下中青年肠造口患者及其主要照护者护理依赖的二元应对体验，为提升护理依赖体验和家庭弹性水平提供依据。方法采用目的抽样法，选取2023年1月—12月在武汉市某三级甲等医院肿瘤防治中心或伤口造口门诊就诊的18例中青年肠造口患者及其主要照护者进行半结构式访谈，采用内容分析法对访谈资料进行分析。结果共提炼出4个主题和8个亚主题，分别为重度依赖-弹性疲劳-弱弹性（患者造口回避，意志消沉，照护者无奈接受；患者角色强化，过分依赖，照护者筋疲力尽）；中度依赖-弹性调适-强弹性趋势（积极探索，互相理解，感知支持；重心调整，互相依赖，关系向好）；轻度依赖-弹性空间-强弹性（自我可控，快速适应，共同成长；坦然面对，珍惜生命，重塑价值）；无依赖-弹性渐断-弱弹性趋势（拒绝求助，自我孤立，关系裂痕；求助受挫，自我保护，关系疏远）；并初步提出中青年肠造口患者家庭弹性模型。结论中青年肠造口患者及其主要照护者护理依赖的二元应对及家庭弹性具有异质性和动态性，应重视以家庭为中心的支持，促进二者积极应对，提高家庭弹性水平。此外，该研究还尝试性提出基于护理依赖的中青年肠造口患者家庭弹性模型，丰富了家庭弹性的内涵。

关键词: 肠造口, 护理依赖, 家庭弹性, 照护者, 质性研究, 护理

Abstract:

Objective To explore the dual coping experience of nursing dependence among middle-aged and young patients with enterostomy and their primary caregivers from the perspective of family resilience，in order to provide evidence for improving the experience of nursing dependence and promoting family resilience. Methods Using the phenomenological research method in qualitative research，18 young and middle-aged enterostomy patients and their primary caregivers were selected for semi-structured interviews with purpose sampling method，and the interview data were analyzed by content analysis method. Results A total of 4 themes and 8 sub-themes were extracted. Theme 1：heavy dependence-elastic fatigue-weak resilience（patients avoid stomas，depression，caregivers helplessly accepting；patients role reinforcement，excessive dependence，caregivers exhaustion）；theme 2：moderate dependence-elastic adjustment-strong resilience trend（active exploration，mutual understanding，perceived support；focus adjustment，mutual dependence，positive relationship）；theme 3：mild dependence-elastic space-strong resilience（self-controllable feeling，quick adaptation，mutual growth；facing calmly，cherishing life，reshaping value）；theme 4：no dependence-gradual loss of elasticity-weak resilience trend（refusal to seek help，self isolation，relationship cracks；frustration in seeking help，self-protection，relationship alienation）. In this article，we proposed a preliminary family resilience model for patients with enterostomy. Conclusion The dual coping and family resilience of the patients with enterostomy and their primary caregivers are different and dynamic. Family-centered support should be applied to strengthen the positive coping and improve the level of family resilience. In addition，this study also tried to propose a family resilience model for patients with enterostomy based on nursing dependence，in order to enrich the connotation of family resilience.

Key words: Enterostomy, Nursing Dependency, Family Resilience, Caregivers, Qualitative Research, Nursing Care

杨阳, 刘美, 熊沫, 冯丽娟, 杨纯子. 中青年肠造口患者及其主要照护者护理依赖二元应对体验的质性研究[J]. 中华护理杂志, 2025, 60(4): 389-395.

YANG Yang, LIU Mei, XIONG Mo, FENG Lijuan, YANG Chunzi. A qualitative study on the dual coping experience of nursing dependence among middle-aged and young patients with enterostomy and their primary caregivers[J]. Chinese Journal of Nursing, 2025, 60(4): 389-395.

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