老年肺癌患者术后过渡期肺康复行为影响因素的质性研究

doi:10.3761/j.issn.0254-1769.2024.01.002

摘要/Abstract

摘要：

目的探讨老年肺癌患者术后过渡期肺康复行为的影响因素，为制订老年肺癌患者过渡期肺康复方案以及提高肺康复依从性提供依据。方法基于能力、机会、动机-行为（capability，opportunity and motivation-behavior，COM-B）模型，通过描述性质性研究方法，利用目的抽样法选取2022年3月—7月在天津市某三级甲等肿瘤专科医院的12例老年肺癌术后患者进行半结构式访谈，使用定向内容分析法进行资料分析。结果共提炼出能力因素（老年人体力及术后不适症状限制肺康复锻炼；肺康复知识缺乏，意识不到锻炼的重要性），机会因素（基层医疗卫生服务缺乏，限制肺康复锻炼；家人及朋友是促进肺康复锻炼的重要资源；医护支持为促进肺康复锻炼保驾护航），动机因素（运动自我效能高是进行肺康复锻炼的基础；感知到肺康复效果，增加肺康复锻炼的动力）等3个主题及7个亚主题。结论老年肺癌患者术后过渡期肺康复过程中存在一定的阻碍因素及促进因素，需要改善其术后不适症状，增加其肺康复相关知识，提高肺康复意识，正视家庭、朋友、医护人员的社会支持作用，完善基础设施及肺康复体系，增加社区肺康复支持，提供多渠道优质肺康复资源，促进智慧医疗服务发展，构建适合老年肺癌患者术后过渡期的肺康复策略。

关键词: 老年, 肺癌, 过渡期, 肺康复, 影响因素, 质性研究, 康复护理

Abstract:

Objective To understand the factors that affect the pulmonary rehabilitation behavior of elderly patients with lung cancer during the post-operative transitional period，and provide reference bases for formulating the pulmonary rehabilitation plan of elderly patients with lung cancer during the transitional period and improving the compliance of pulmonary rehabilitation. Methods Based on the capability，opportunity，and motivation-behavior model（COM-B model），12 elderly lung cancer patients who underwent surgery at a tertiary A tumor hospital in Tianjin from March to July 2022 were selected for semi-structured interviews using descriptive research methods and purposive sampling method. The data were analyzed using directed content analysis. Results The ability factors （physical strength and postoperative discomfort symptoms of the elderly limit lung rehabilitation exercise，lack of pulmonary rehabilitation knowledge and awareness of the importance of exercise in lung rehabilitation knowledge），opportunity factors（lack of grassroots medical and health services，limiting lung rehabilitation exercise；family and friends are important resources for promoting lung rehabilitation exercise；medical support is a guarantee for promoting lung rehabilitation exercise），motivational factors（high self-efficacy in exercise is the foundation for lung rehabilitation exercise，perception of lung rehabilitation effects increases motivation for lung rehabilitation exercise） and 7 sub themes were extracted. Conclusion There are certain obstacles and promoting factors in the transitional lung rehabilitation process for elderly lung cancer patients after surgery. It is necessary to improve their postoperative discomfort symptoms，increase their knowledge of lung rehabilitation，enhance their awareness of lung rehabilitation，face the social support role of family，friends，and medical staff，improve the infrastructure and lung rehabilitation system，increase community lung rehabilitation support，provide multi-channel high-quality lung rehabilitation resources，and promote the development of smart medical services，constructing a transitional lung rehabilitation strategy for elderly patients with lung cancer.

Key words: Elderly, Lung Cancer, Transitional Periods, Pulmonary Rehabilitation, Influencing Factor, Qualitative Research, Rehabilitation Nursing

朱虹宣, 庞建美, 孙盛楠, 李燕. 老年肺癌患者术后过渡期肺康复行为影响因素的质性研究[J]. 中华护理杂志, 2024, 59(1): 15-21.

ZHU Hongxuan, PANG Jianmei, SUN Shengnan, LI Yan. A qualitative study of the factors of pulmonary rehabilitation behavior of elderly patients with lung cancer in the post-operative transitional period[J]. Chinese Journal of Nursing, 2024, 59(1): 15-21.

图/表 1

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