经鼻肠管菌群移植患者治疗体验及需求的质性研究

doi:10.3761/j.issn.0254-1769.2022.17.011

摘要/Abstract

摘要：

目的深入了解经鼻肠管菌群移植患者治疗期间的体验及需求,为医护人员制订干预措施提供依据。方法采用目的抽样法,对2021年6月—7月在上海市某三级甲等医院肠道微生态诊疗中心接受经鼻肠管菌群移植治疗的13例患者进行半结构式访谈,运用Colaizzi 7步分析法对资料进行编码、归纳后提炼主题。结果将经鼻肠管菌群移植患者的治疗体验及需求归纳为3个主题。①治疗期间生理舒适度较低：咽喉部干涩疼痛;排便形态紊乱;胃肠道刺激。②治疗期间对菌群移植的态度发生变化：菌群移植前,期待移植;知晓菌群来源后,排斥与妥协;未达预期疗效时,失落与质疑;症状日渐改善后,坚定移植信念。③治疗期间的需求：家属、朋友的情感支持;医护人员的专业指导;居家康复的延续性支持。结论经鼻肠管菌群移植患者治疗期间生理舒适度较低,随治疗的推进,患者对菌群移植的态度发生变化,且存在迫切的外部支持需求。医护人员需关注菌群移植患者的生理体验、心理感受和支持需求,并采取有效的干预措施,以提升患者的身心舒适度、促进疾病恢复。

关键词: 菌群移植, 鼻肠管, 体验, 需求, 质性研究, 护理

Abstract:

Objective To explore the experience and needs of patients with fecal microbiota transplantation via naso-jejunal tube,in order to provide evidence for medical staff to conduct interventions. Methods Descriptive phenomenological method was used in this research. From June 2021 to July 2021,13 patients receiving fecal microbiota transplantation were recruited from a tertiary hospital in Shanghai to conduct a semi-structured interview. Data was analyzed by Colaizzi phenomenon analytical method. Results The treatment experience and needs of patients receiving fecal microbiota transplantation via naso-jejunal tube were grouped into 3 themes,including physiological discomfort during treatment（dry and painful throat,disordered defecation,gastrointestinal irritation）,the change of attitude towards fecal microbiota transplantation （expectation on transplantation before the fecal microbiota transplantation,dislike but compromise when knowing the source of microbiota,disappointment and doubt when the efficacy did not meet expectation,firming faith when disease improved）,needs during treatment（spiritual support from family and friends,education from medical staff,continued support of home rehabilitation）. Conclusion Patients receiving fecal microbiota transplantation via naso-jejunal tube experienced physiological discomfort,and their attitudes towards fecal microbiota transplantation show dynamic changes during treatment and the urgent need for external support. It suggested that medical staff should pay attention to the expression of physiological and inner feelings of patients,and take practical measures to improve physical and mental experience,in order to meet their individualized needs and promote disease recovery.

Key words: Fecal Microbiota Transplantation, Naso-Jejunal Tube, Experience, Need, Qualitative Research, Nursing Care

李燕, 周筛兰, 王开, 杨晓培, 刘倩, 于晓丽, 田宏亮, 朱晓萍. 经鼻肠管菌群移植患者治疗体验及需求的质性研究[J]. 中华护理杂志, 2022, 57(17): 2116-2122.

LI Yan, ZHOU Shailan, WANG Kai, YANG Xiaopei, LIU Qian, YU Xiaoli, TIAN Hongliang, ZHU Xiao-ping. Experience and needs of patients with fecal microbiota transplantation via Naso-jejunal tube：a qualitative study[J]. Chinese Journal of Nursing, 2022, 57(17): 2116-2122.

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