减重代谢术后患者饮食依从性影响因素的质性研究

doi:10.3761/j.issn.0254-1769.2021.01.009

摘要/Abstract

摘要：

目的探讨减重代谢术后患者饮食依从性的影响因素。方法基于态度-社会影响-自我效能模型,通过描述性质性研究,利用目的抽样法选取2019年11月—12月于江苏省某三级甲等综合医院复诊的20例减重代谢术后患者进行半结构式访谈,运用定向内容分析法进行资料分析。结果归纳出态度（有益身心的积极态度、不适体验的消极态度）、社会影响（重要人物的主观规范、指令性规范、描述性规范）、自我效能（应对主观情境的自我效能低下、应对客观情境的自我效能低下）共3个主题和7个亚主题。结论术后患者饮食依从性的促进因素包括积极态度、重要人物的正面影响,阻碍因素包括消极态度、重要人物的负面影响、低水平的自我效能。针对上述因素,医护人员应及时进行有效评估和干预,从而提高患者的饮食依从性,改善临床结局。

关键词: 减重代谢手术, 摄食行为, 依从性, 质性研究, 外科护理学

Abstract:

Objective To provide an in-depth description of factors that influence postoperative patients’ dietary adherence who underwent bariatric surgery. Methods A qualitative description was conducted based on Attitude—Social influence—Self-efficacy model. 20 postoperative patients in a level A tertiary hospital in Jiangsu were selected by the purposive sampling and were interviewed in a semi-structured way from November to December 2019. The data was categorized and analyzed by directed content analysis. Results The final analysis yielded a total of 7 generic categories belonging to 3 categories. These were attitude（positive attitude that benefits to physical and mental health;uncomfortable negative attitude and experience）,social influence（subjective norms,injunctive norms and descriptive norms of important people）,self-efficacy（low self-efficacy in dealing with subjective situations and low self-efficacy in dealing with objective situations）. Conclusion The facilitators of postoperative patients’ dietary adherence included positive attitude and positive effect of important people. The barriers included negative attitude,negative effect of important people and low self-efficacy. Health workers should make evaluation and interventions based on these factors,which can improve patients’ dietary adherence and clinical outcomes.

Key words: Bariatric Surgery, Feeding Behavior, Adherence, Qualitative Study, Surgical Nursing

朱涵菲,杨宁琍,任子淇,赵康,蒋小曼,许勤. 减重代谢术后患者饮食依从性影响因素的质性研究[J]. 中华护理杂志, 2021, 56(1): 56-61.

ZHU Hanfei,YANG Ningli,REN Ziqi,ZHAO Kang,JIANG Xiaoman,XU Qin. Influencing factors of dietary adherence among patients following bariatric surgery:a qualitative study[J]. Chinese Journal of Nursing, 2021, 56(1): 56-61.

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