Abstract:

Objective This study explored the engagement experience change of postpartum patients with diastasis recti abdominis at different stages of rehabilitation，and provided references for the clinical practice. Methods This study employed purposive sampling method to select 18 postpartum patients with diastasis recti abdominis in an obstetric clinic of a tertiary hospital in Shanxi Province from September 2024 to March 2025 as research subjects. According to the “patient health engagement” model，4 semi-structured interviews were conducted with patients. The data was analyzed by the interpretative phenomenological analysis. Results A total of 4 themes and 16 subthemes were extracted，including limited function and insufficient disease awareness during blackout period（physical limitations，body image disturbance，psychological stress from social and family expectations，insufficient understanding of disease pathology and consequences），inadequate disease response during arousal period （deficiency in rehabilitation skills，insufficient ability to discriminate rehabilitation information，facing concerns about multiple role conflicts，lack of confidence in disease rehabilitation，disconnection between rehabilitation plans and daily life），insufficient support for diseases during adhesion period（incorrect disease attributions and blame among family members，imbalance in the distribution of parenting responsibilities within the family，insufficient support for community medical services，needs for improved continuity of medical service support），benefit finding during eudaimonic period（well recovery of physical functions，increased satisfaction with body and enhanced social confidence，positive rehabilitation role transformation）. Conclusion In different stages of rehabilitation engagement，the experience of patients is changing dynamically，and medical staff should provide individualized professional support systematically according to the care experience to promote their level of rehabilitation participation and improve the overall rehabilitation outcomes.

Key words: Diastasis Recti Abdominis, Patient Health Engagement Model, Qualitative Research, Rehabilitation Nursing

摘要：

目的 探讨产后腹直肌分离患者康复期间不同阶段的参与体验变化，为临床实践提供依据。方法 采用目的抽样法，选取2024年9月—2025年3月在山西省某三级甲等医院妇产科门诊的18例参与产后腹直肌分离康复治疗的患者作为研究对象。基于患者健康参与模型，对每例患者进行4次半结构式访谈，采用解释现象学分析法整理、分析资料。结果 共提炼出空白期身心功能受限，疾病认知不足（躯体功能限制、身体意向紊乱、社会及家庭期待的心理压力、疾病病理及后果认知不足）；觉醒期疾病康复应对能力不足（康复技能欠缺、康复信息鉴别能力不足、面对多角色冲突的担忧、疾病康复信心不足、康复计划与生活脱节）；依赖期疾病康复参与支持力度不足（家庭成员错误的疾病归因与指责、家庭育儿责任分配失衡、社区医疗服务支持欠缺、医疗服务支持的连续性有待提高）；自我实现期疾病获益感体验良好（躯体功能恢复良好、身体满意度提升，社交信心增强、正向康复角色转变）4个主题，共16个亚主题。结论 在产后腹直肌分离康复的不同阶段，患者的体验呈动态变化，医护人员应根据不同阶段的康复参与体验，提供个体化专业支持，促进其康复参与水平，提高整体康复效果。

关键词: 腹直肌分离, 患者健康参与模型, 质性研究, 康复护理