Abstract:

Objective To explore the facilitating and hindering factors for the caregivers of elderly frail patients with traumatic brain injury（TBI） during the early stage of rehabilitation，and to provide a basis for formulating precise intervention strategies. Methods Based on the theoretical domain framework，using a two-stage content analysis method，semi-structured interviews were conducted with the caregivers of elderly TBI frail patients who needed inpatient rehabilitation at a tertiary general hospital and a brain health rehabilitation hospital in Zhejiang Province from July to August 2025. Results Totally 5 facilitating factors（positive prognosis expectation，positive psychological adjustment，long-term rehabilitation goal orientation，perceived therapeutic response，and social support acquisition） and 7 hindering factors（poor knowledge reserve，excessive reliance on execution，role overload dilemma，lack of autonomous decision-making，negative rehabilitation perception，resource and condition constraints，psychological and behavioral coordination disorder） were extracted from the 10 theoretical domains. Conclusion In the early stage of rehabilitation，the facilitating and hindering factors for the caregivers of elderly TBI frail patients are diverse. Medical staff should provide differentiated high-quality professional support based on a clear understanding of the facilitating and hindering factors，improve the quality of care provided by the caregivers，and promote the recovery of the patients.

Key words: Traumatic Brain Injury, Frailty, Caregivers, Qualitative Research, Nursing Care

摘要：

目的 探讨老年创伤性脑损伤（traumatic brain injury，TBI）合并衰弱患者在早期运动康复阶段照顾者照护的促进与阻碍因素，为制订相关干预策略提供依据。方法 基于理论域框架，采用两阶段式内容分析法，选择2025年7—8月在浙江省某三级甲等综合医院和某康复医院需住院康复的老年TBI合并衰弱患者的照顾者进行半结构式访谈。结果 10个理论域中提炼出5个促进因素（预后积极期待、正向心理调适、长期康复目标导向、获得治疗响应、获得社会支持）和7个阻碍因素（知识储备欠佳、执行过度依赖、角色过载困境、自主决策缺陷、负性康复感知、资源与条件制约、心理行为协同阻碍）。结论 在早期运动康复阶段，老年TBI衰弱患者照顾者照护的促进与阻碍因素具有多样性，医护人员应在明确促进与阻碍因素的基础上，提供差异化的优质专业支持，提高照顾者的照护质量，促进患者康复和生活质量。

关键词: 创伤性脑损伤, 衰弱, 照顾者, 质性研究, 护理