日间手术跨科收治患者就医体验的纵向质性研究

doi:10.3761/j.issn.0254-1769.2026.16.011

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (16): 2239-2244.DOI: 10.3761/j.issn.0254-1769.2026.16.011

日间手术跨科收治患者就医体验的纵向质性研究

曾颖¹(), 林淑洁¹, 徐文明¹, 谢金懿¹, 温丽静¹, 王梦¹, 饶宜迅², 乔文博³, 卢芳燕⁴^,^*()

¹ 浙江大学医学院附属第一医院胃肠外科杭州市 310003
² 浙江大学医学院附属第一医院内镜中心杭州市 310003
³ 浙江大学医学院附属第一医院重症监护室杭州市 310003
⁴ 浙江大学医学院附属第一医院护理部杭州市 310003

收稿日期:2025-12-10 出版日期:2026-08-20 发布日期:2026-08-14
*通讯作者: 卢芳燕，E-mail：2196032@zju.edu.cn
作者简介:曾颖：女，硕士，副主任护师，护士长，E-mail：1709033@zju.edu.cn
第一联系人：作者贡献声明
曾颖：研究设计、论文撰写；林淑洁：资料收集与分析、论文撰写、基金支持；徐文明、谢金懿：资料收集、论文修改；温丽静、王梦、饶宜迅：资料整理；乔文博：论文审阅与修改；卢芳燕：研究指导
基金资助:
浙江省教育厅一般项目(Y202558427)

A longitudinal qualitative study on the healthcare experience of patients undergoing cross-departmental daytime surgery

ZENG Ying¹(), LIN Shujie¹, XU Wenming¹, XIE Jinyi¹, WEN Lijing¹, WANG Meng¹, RAO Yixun², QIAO Wenbo³, LU Fangyan⁴^,^*()

¹ Department of Gastrointestinal Surgery， the First Affiliated Hospital，Zhejiang University School of Medicine， Hangzhou 310003， China
² Endoscopy Center， the First Affiliated Hospital，Zhejiang University School of Medicine， Hangzhou 310003， China
³ Department of Critical Care Medicine， the First Affiliated Hospital，Zhejiang University School of Medicine， Hangzhou 310003， China
⁴ Department of Nursing， the First Affiliated Hospital，Zhejiang University School of Medicine， Hangzhou 310003， China

Received:2025-12-10 Online:2026-08-20 Published:2026-08-14
* Corresponding author: LU Fangyan，E-mail：2196032@zju.edu.cn
Funding program:
General Project of the Department of Education in Zhejiang Province(Y202558427)

摘要/Abstract

摘要：

目的探讨“全院一张床”模式下日间手术跨科收治患者在不同阶段的就医体验，为优化跨科护理服务流程提供依据。方法采用纵向质性研究方法，通过目的抽样于2025年1—4月选取浙江省某三级甲等医院跨科收治的25例日间手术患者作为研究对象，在住院前准备期、跨科住院期、居家康复期对患者进行3次半结构化访谈，运用Colaizzi 7步分析法，并结合共时分析与历时分析策略提炼主题。结果共提炼出3个纵向主题、8个亚主题。①住院前准备期：跨科信息匮乏引发的不确定感（主动或被动接受跨科收治、接受与忧虑交织）。②跨科住院期：跨科照护体验下的情感起伏（陌生环境下空间与身份的双重错位感、在非专科环境中寻求安全与信任感、等待手术期间信息不对称引发的匆忙及焦虑感、跨科康复指导与实际需求的偏离感）。③居家康复期：体验分化与认知重构（过渡阶段的体验分化、出院后的认知重构）。结论日间手术跨科收治患者的就医体验呈现明显的阶段性及动态变化特征。医护人员应重点关注患者住院前的信息需求、住院期间的情感体验、出院后护理的延续性，并采取分阶段精准干预措施，切实改善此类患者的就医体验并保障医疗安全。

关键词: 日间手术, 全院一张床, 就医体验, 质性研究, 护理管理研究

Abstract:

Objective To explore the healthcare experiences of patients undergoing cross-departmental daytime surgery under the “hospital-wide bed management” model across different stages，and to provide evidence for optimizing cross-departmental nursing service processes. Methods A longitudinal qualitative research design was adopted. A total of 25 patients who underwent cross-departmental daytime surgery in a tertiary hospital in Zhejiang Province from January to April 2025 were recruited via purposive sampling. 3 semi-structured interviews were conducted during the pre-hospital preparation period，the cross-departmental hospitalization period，and the home recovery period. Data were analyzed using Colaizzi’s seven-step analysis method combined with synchronic and diachronic analysis strategies to extract themes. Results A total of 3 longitudinal themes and 8 sub-themes were extracted：①Pre-hospital preparation period：uncertainty caused by lack of cross-departmental information（active or passive acceptance of cross-departmental admission，intertwined expectations and worries）. ②Cross-departmental hospitalization period：emotional fluctuations under cross-departmental care experience（dual sense of dislocation in space and identity in an unfamiliar environment，seeking security and trust in a non-specialized ward setting，anxiety caused by information asymmetry during preoperative waiting，sense of deviation between cross-departmental rehabilitation guidance and actual needs）. ③Home recovery period：experience differentiation and cognitive recon-struction（experience differentiation during the transitional phase，cognitive reconstruction after discharge）. Conclusion The healthcare experiences of patients undergoing cross-departmental daytime surgery show significant dynamic changes across different phases. Healthcare providers should focus on patients’ information needs before admission，emotional experiences during hospitalization，and continuous post-discharge care and implement phase-specific targeted interventions to effectively improve patient experience and ensure medical safety.

Key words: Daytime Surgery, Hospital-Wide Bed Management, Patient Experience, Qualitative Research, Nursing Administration Research

曾颖, 林淑洁, 徐文明, 谢金懿, 温丽静, 王梦, 饶宜迅, 乔文博, 卢芳燕. 日间手术跨科收治患者就医体验的纵向质性研究[J]. 中华护理杂志, 2026, 61(16): 2239-2244.

ZENG Ying, LIN Shujie, XU Wenming, XIE Jinyi, WEN Lijing, WANG Meng, RAO Yixun, QIAO Wenbo, LU Fangyan. A longitudinal qualitative study on the healthcare experience of patients undergoing cross-departmental daytime surgery[J]. Chinese Journal of Nursing, 2026, 61(16): 2239-2244.

图/表 1

参考文献 16

[1]	国家卫生健康委, 国家中医药局. 关于开展改善就医感受提升患者体验主题活动的通知[EB/OL].(2023-05-26)[2025-11-26]. https://www.gov.cn/zhengce/zhengceku/202305/content_6883385.htm.
	National Health Commission, National Administration of Tradi-tional Chinese Medicine. Notice on carrying out the thematic activity of improving medical experience and enhancing patient experience[EB/OL].(2023-05-26)[2025-11-26]. https://www.gov.cn/zhengce/zhengceku/202305/content_6883385.htm.
[2]	刘艳, 曾颖, 张莉莉, 等. “全院一张床”模式下在职护士继续教育培训障碍和促进因素的质性研究[J]. 护理与康复, 2024, 23(9):32-35,42.
	Liu Y, Zeng Y, Zhang LL, et al. Qualitative study on obstacles and promoting factors of continuing education and training for in-service nurses under the mode of “one bed in the whole hospital”[J]. J Nurs Rehabil, 2024, 23(9):32-35,42.
[3]	国家卫生健康委医院管理研究所日间医疗专家库, 《日间手术全流程护理管理专家共识》专家工作组. 日间手术全流程护理管理专家共识[J]. 中华医院管理杂志, 2024, 40(10):761-768.
	Day Surgery Medical Expert Pool of National Institute of Hospital Administration,National Health Commission, Expert Working Group of “Expert Consensus on Whole-Process Nurs-ing Management of Day Surgery”. Expert consensus on whole-process nursing management of day surgery[J]. Chin J Hosp Admin, 2024, 40(10):761-768.
[4]	黄浩, 朱纯良, 石耀罡. “全院一张床”管理模式的实践与效果评价[J]. 中国卫生质量管理, 2024, 31(12):36-39.
	Huang H, Zhu CL, Shi YG. The practice and effect evaluation of “one bed in the whole hospital” management mode[J]. Chin Health Qual Manag, 2024, 31(12):36-39.
[5]	沈蓝君, 夏露, 程云. 老年日间手术患者延续护理需求现状及影响因素研究[J]. 中华护理杂志, 2022, 57(21):2622-2628.
	Shen LJ, Xia L, Cheng Y. Current situation and influencing factors of transitional care needs of elderly patients undergo-ing ambulatory surgery[J]. Chin J Nurs, 2022, 57(21):2622-2628.
[6]	曹俊华, 周莉莉, 杨旻斐, 等. 以四重目标理论为指导同质化管理急诊跨科收治患者的效果评价[J]. 中华急危重症护理杂志, 2024, 5(11):985-990.
	Cao JH, Zhou LL, Yang MF, et al. Effect evaluation of homoge-neous nursing management for cross-disciplinary admission of emergency patients under the quadruple objective theory[J]. Chin J Emerg Crit Care Nurs, 2024, 5(11):985-990.
[7]	弓玉红, 袁丽荣, 孟效红, 等. 基于风险管理的全院“一张床”管理模式的构建与应用[J]. 护理研究, 2024, 38(12):2230-2232.
	Gong YH, Yuan LR, Meng XH, et al. Construction and appli-cation of “one bed” management model based on risk mana-gement[J]. Chin Nurs Res, 2024, 38(12):2230-2232.
[8]	陈灵熙, 周云仙. 我国护理领域纵向质性研究文献分析[J]. 中华护理教育, 2022, 19(2):113-118.
	Chen LX, Zhou YX. Analysis of status of longitudinal quali-tative research in nursing in China[J]. Chin J Nurs Educ, 2022, 19(2):113-118.
[9]	刘明. Colaizzi七个步骤在现象学研究资料分析中的应用[J]. 护理学杂志, 2019, 34(11):90-92.
	Liu M. Using an example to illustrate Colaizzi’s phenomenolo-gical data analysis method[J]. J Nurs Sci, 2019, 34(11):90-92.
[10]	熊英. 全院床位统一调配模式运行现状及影响因素研究[D]. 重庆: 重庆医科大学, 2024.
	Xiong Y. A study on the current situation and influencing factors of the hospital-wide bed-sharing model[D]. Chongqing: Chongqing Medical University, 2024.
[11]	Du QH, Zhang ZC, Yang Y, et al. How health seeking beha-vior develops in patients with type 2 diabetes:a qualitative study based on health belief model in China[J]. Front Public Health, 2024, 12:1414903. DOI URL
[12]	叶磊, 荣芸, 丁洁芳, 等. 基于虚拟现实技术的干预对减轻成人患者术前焦虑效果的Meta分析[J]. 中华护理杂志, 2022, 57(11):1310-1317. DOI
	Ye L, Rong Y, Ding JF, et al. The effect of virtual reality intervention on improving preoperative anxiety in adult patients:a meta analysis[J]. Chin J Nurs, 2022, 57(11):1310-1317.
[13]	Thoen CW, Sæle M, Strandberg RB, et al. Patients’ experiences of day surgery and recovery:a meta-ethnography[J]. Nurs Open, 2024, 11(1):e2055. DOI URL
[14]	袁芳, 冯勤, 钱援芳, 等. 基于有限时间理论的日间手术全流程护理清单的构建与应用[J]. 中华护理杂志, 2024, 59(10):1226-1232. DOI
	Yuan F, Feng Q, Qian YF, et al. Construction and application of a nursing list for whole process of day surgery based on the theory of limited time[J]. Chin J Nurs, 2024, 59(10):1226-1232. DOI
[15]	冯洁惠, 殷钰, 吴一女, 等. 专科护士主导的跨学科协作照护模式的构建与实践研究[J]. 中华护理杂志, 2025, 60(23):2821-2828. DOI
	Feng JH, Yin Y, Wu YN, et al. Development and implementa-tion of an interdisciplinary collaborative care model led by specialty nurses[J]. Chin J Nurs, 2025, 60(23):2821-2828.
[16]	Sawhney M, Teng L, Jussaume L, et al. The impact of patient navigation on length of hospital stay and satisfaction in patients undergoing primary hip or knee arthroplasty[J]. Int J Orthop Trauma Nurs, 2021, 41:100799.

日间手术跨科收治患者就医体验的纵向质性研究

A longitudinal qualitative study on the healthcare experience of patients undergoing cross-departmental daytime surgery

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