慢性阻塞性肺疾病患者运动恐惧的发生机制研究及护理对策

doi:10.3761/j.issn.0254-1769.2025.21.008

摘要/Abstract

摘要：

目的探究慢性阻塞性肺疾病患者运动恐惧的发生机制，为制订临床护理干预措施提供参考。方法运用目的抽样法和理论抽样法，选取2025年1—4月在青岛市某三级甲等医院呼吸内科住院和门诊就诊的15例存在运动恐惧的慢性阻塞性肺疾病患者进行半结构化访谈，并采用程序化扎根理论方法对资料进行分析。结果访谈总时长为427 min，转录文字共计7.8万余字。构建的慢性阻塞性肺疾病患者运动恐惧发生机制涵盖运动恐惧触发事件、非理性认知评估、恐惧情绪唤醒、不良应对模式、外显行为反应5个核心范畴。结论构建的慢性阻塞性肺疾病患者运动恐惧发生机制有助于指导医护人员识别多种运动恐惧触发事件，通过提升锻炼感知益处水平、缓解恐惧情绪以及减少回避行为，降低患者的运动恐惧程度。

关键词: 肺疾病，慢性阻塞性, 运动恐惧, 发生机制, 扎根理论, 护理

Abstract:

Objective To explore the mechanism of kinesiophobia in patients with chronic obstructive pulmonary disease，in order to provide references for the formulation of clinical nursing intervention measures. Methods From January to April 2025，purpose sampling and theoretical sampling were used to select 15 COPD patients with kinesiophobia in the inpatient department and outpatient department of Respiratory Medicine in a tertiary A hospital in Qingdao for semi-structured in-depth interviews. The data were analyzed by the procedural grounded theory method. Results The total length of the interview was 427 min，and the total number of transcribed words was more than 78 000 Chinese words. The mechanism model of kinesiophobia in patients with COPD was established，including 5 core categories of kinesiophobia trigger events，irrational cognitive assessment，fear emotional arousal，adverse coping mode and explicit behavioral response. Conclusion The mechanism model of kinesiophobia in patients with COPD can guide medical staff to identify multi-source triggers of kinesiophobia，and reduce the level of kinesiophobia by enhancing the perceived benefits of exercise，alleviating fear and reducing avoidance behavior.

Key words: Pulmonary Disease，Chronic Obstructive, Kinesiophobia, Pathogenesis, Grounded Theory, Nursing Care

吴瑞芝, 杜云红, 黄菊, 周佩夏, 陈小杰, 宋艳如, 王莉. 慢性阻塞性肺疾病患者运动恐惧的发生机制研究及护理对策[J]. 中华护理杂志, 2025, 60(21): 2613-2619.

WU Ruizhi, DU Yunhong, HUANG Ju, ZHOU Peixia, CHEN Xiaojie, SONG Yanru, WANG Li. Study on the mechanism of kinesiophobia in patients with chronic obstructive pulmonary disease and nursing countermeasures[J]. Chinese Journal of Nursing, 2025, 60(21): 2613-2619.

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