急性心肌梗死介入术后患者恐惧体验及应对需求的质性研究

doi:10.3761/j.issn.0254-1769.2026.02.003

摘要/Abstract

摘要：

目的探讨急性心肌梗死（acute myocardial infarction，AMI）患者行经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）术后的恐惧体验及应对需求，为制订个体化的心理干预与延续性护理策略提供理论依据与实践指导。方法采用目的抽样法，于2024年9—12月在哈尔滨市某三级甲等综合医院选取22例接受PCI治疗的AMI患者作为研究对象，进行半结构化访谈，并运用内容分析法对资料进行分析。结果提炼出5个主题和11个亚主题，包括疾病认知偏差强化恐惧体验（疾病误判引发的恐惧冲击、疾病归因模糊导致的不可控性恐惧）、疾病阶段情境中恐惧体验的时序性演变（发病时的极度恐惧体验、术后恢复期的持续恐惧体验）、恐惧驱动下的应对策略转化（健康信念重构、生活习惯调整）、恐惧情绪对生活与心理状态的持续影响（日常生活限制与生活质量担忧、心理健康困扰）、应对恐惧的多维支持需求（对医护指导的专业性和个性化需求、对康复服务可及性与医保连续性的需求、对家庭陪伴与同伴支持的需求）。结论 AMI患者PCI术后的恐惧体验具有显著的多维性特征及需求。在临床实践中护士应全面评估患者的疾病认知与应对需求，早期识别其术后恐惧来源，结合个体差异实施针对性的健康教育与心理支持，促进其情绪调节与健康行为的持续转化，提升术后康复质量与生活适应能力。

关键词: 急性心肌梗死, 经皮冠状动脉介入治疗, 恐惧, 自我调节常识模型, 质性研究, 护理

Abstract:

Objective To explore the fear experiences and coping needs of patients with acute myocardial infarction（AMI） following percutaneous coronary intervention（PCI），and to provide theoretical and practical guidance for the development of individualized psychological interventions and continuity of care strategies. Methods Using purposive sampling，22 patients with AMI who underwent PCI were recruited from a tertiary general hospital in Harbin，China，between Septemberand December 2024 as research participants. Semi-structured interviews were conducted，and the data were analyzed using content analysis. Results A total of 5 major themes and 11 sub-themes were identified: cognitive misperceptions intensifying fear experience（emotional shock induced by illness misinterpretation，fear of uncontrollability resulting from ambiguous causal attributions）；temporal evolution of fear across disease stages（intense fear at onset and persistent fear during postoperative recovery）；fear-driven transformation of coping strategies（health belief reconstruction and lifestyle adjustment）；lasting impact of fear on life and psychological state（limitations in daily activities and concerns about quality of life，emotional distress and psychological disturbance); multidimensional support needs in coping with fear（professional and individualized guidance from healthcare providers, accessibility of rehabilitation services and continuity of health insurance coverage， companionship from family members and support from peers）. Conclusion Fear experiences among AMI patients after PCI exhibit multidimensional characteristics and are accompanied by significant psychological and practical needs. Clinical nurses should conduct comprehensive assessments of patients’ illness perceptions andneeds for coping，early identify sources of fear，and provide targeted health education and psychological support based on individual differences. These efforts can facilitate emotional regulation，promote sustained health behavior transformation，and ultimately improve postoperative recovery and adaptation.

Key words: Acute Myocardial Infarction, Percutaneous Coronary Intervention, Fear, Common-Sense Model of Self-Regulation, Qualitative Research, Nursing

吴晓敏, 谷艳荣, 柴依依, 马心蕊, 朱豆, 张政, 林平, 李玲. 急性心肌梗死介入术后患者恐惧体验及应对需求的质性研究[J]. 中华护理杂志, 2026, 61(2): 166-173.

WU Xiaomin, GU Yanrong, CHAI Yiyi, MA Xinrui, ZHU Dou, ZHANG Zheng, LIN Ping, LI Ling. Fear experiences and coping needs of patients with acute myocardial infarction after percutaneous coronary intervention：a qualitative study[J]. Chinese Journal of Nursing, 2026, 61(2): 166-173.

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