老年类风湿关节炎患者对跌倒警觉体验的质性研究

doi:10.3761/j.issn.0254-1769.2025.07.011

摘要/Abstract

摘要：

目的了解老年类风湿关节炎患者的跌倒警觉体验，为制订针对性跌倒预防策略提供参考。方法采取目的抽样法，选取2024年2月—4月贵州省某三级甲等综合医院风湿免疫科收治的13例老年类风湿关节炎患者，采用现象学研究方法对其进行半结构式深入访谈，运用Colaizzi七步法进行资料分析，提炼主题。结果共提炼出跌倒风险感知过程（重塑跌倒风险认知、建立情绪应对机制、强化跌倒警觉效应）、跌倒警觉行为响应（营造安全居住环境、规律生活作息计划）、跌倒预防支持需求（跌倒预防知识需求、居家护理服务需求、智能设备使用需求、心理社会支持需求）3个主题，9个亚主题。结论临床医护人员应重视老年类风湿关节炎患者的跌倒风险感知转变过程，在实践中精准识别患者的跌倒支持需求，探索跌倒需求支持的交互路径及构建社会支持网络体系，以指导患者采取适宜的跌倒警觉响应行为，提高患者的跌倒警觉，降低其跌倒风险。

关键词: 老年人, 类风湿性关节炎, 跌倒警觉, 心理体验, 质性研究, 护理

Abstract:

Objective To understand the experience of fall alertness in elderly patients with rheumatoid arthritis and to provide references for the development of targeted nursing intervention strategies. Methods 13 elderly patients with rheumatoid arthritis，who were admitted to the Department of Rheumatology and Immunology of a tertiary hospital in Guizhou Province from February to April 2024，were selected through purposive sampling. Phenomenological qualitative research methods were used，with semi-structured in-depth interviews. Data were analyzed using Colaizzi’s seven-step method，and themes were extracted. Results 3 main themes and 9 sub-themes were identified：the process of fall risk perception（reshaping fall risk cognition，establishing emotional coping mechanism，enhancing fall alertness effect），behavioral responses to fall alertness（creating a safe living environment，regularizing daily routine plan），and needs for fall prevention support（need for fall prevention knowledge，home rehabilitation care needs，intelligent device usage needs，psychosocial support needs）. Conclusion Clinical medical staff should pay attention to the transformation process of fall risk perception in elderly rheumatoid arthritis patients，accurately identify patients’ fall support needs in practice，and guide patients to adopt appropriate fall alert response behaviors through innovative fall demand support interaction paths and the construction of social support network systems，in order to improve patients’ fall alertness and reduce their fall risk.

Key words: Aged, Rheumatoid Arthritis, Fall Alertness, Psychological Experience, Qualitative Research, Nursing Care

吴丽萍, 肖丽娜, 赖菡青, 黄倩, 郭璇, 周迅. 老年类风湿关节炎患者对跌倒警觉体验的质性研究[J]. 中华护理杂志, 2025, 60(7): 836-841.

WU Liping, XIAO Lina, LAI Hanqing, HUANG Qian, GUO Xuan, ZHOU Xun. Qualitative study on the experience of fall alertness in elderly patients with rheumatoid arthritis[J]. Chinese Journal of Nursing, 2025, 60(7): 836-841.

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