Abstract:

Objective This study applies Roy adaptation theory to deeply explore the experience of food avoidance behavior in patients with inflammatory bowel disease（IBD），offering insights for developing dietary management strategies. Methods A descriptive qualitative research method was employed. By purposive sampling，24 IBD patients hospitalized in the gastroenterology department of a tertiary hospital in Nanjing from July 2022 to December 2024 were selected for semi-structured interviews. Data were analyzed using a directed content analysis approach. Results This study identified 4 main themes and 11 sub-themes，encompassing overattribution leading to inappropriate avoidance（recurrent symptoms triggering overattribution，disease staging triggering inappropriate avoidance），negative self-perception leading management struggles（illness fear diminishing self-efficacy，disease trauma eroding self-identity，knowledge deficiency constraining self-determination），functional impairment intensifying role challenges（role internalization undermining social function，social roles relinquishing dietary management），and external constraints amplifying practical difficulties（family and friend oversight heightening dietary stress，healthcare gaps fostering practical helplessness，traditional beliefs restricting dietary exploration，economic hardship limiting balanced nutrition）. Conclusion The interplay of overattribution，negative self-perception，functional impairment，and external constraints in IBD patients hinders their ability to adapt to disease fluctuations，ensnaring them in the adaptive predicament of food avoidance behavior. Healthcare professionals should comprehensively address these factors by fostering accurate perceptions，enhancing psychological support，guiding effective coping strategies，and optimizing external resources，thereby improving patients’ overall adaptive capacity and promoting their recovery.

Key words: Inflammatory Bowel Disease, Roy Adaptation Theory, Dietary, Qualitative Research, Nursing Care

摘要：

目的 基于罗伊适应理论深入探讨炎症性肠病（inflammatory bowel disease，IBD）患者回避饮食体验，为制订IBD患者饮食管理方案提供参考。方法 采用目的抽样法，选取2022年7月—2024年12月在南京市某三级甲等医院消化内科住院的24例IBD患者进行半结构式访谈，采用定向内容分析法进行资料分析。结果 共提炼出4个主题及11个亚主题，包括过度归因导致不当回避（症状反复诱导过度归因、疾病分期引发不当回避），消极自我导致管理困境（疾病恐惧降低自我效能、疾病创伤损害自我认同、知识缺乏限制自我决策），功能受损加剧角色困境（角色内化削弱社会功能、社会角色割舍饮食管理），外部制约强化实践困境（亲友监管加剧饮食压力、医疗缺位导致实践无助、传统观念束缚饮食尝试、经济负担限制均衡膳食）。结论 IBD患者的过度归因、消极自我、功能受损和外部制约的交互影响使其难以适应疾病变化，陷入回避饮食行为的困境。医护人员应综合考虑上述因素，通过建立正确认知，加强心理支持，引导正确应对，优化外部资源，提高患者的整体适应能力，促进其健康恢复。

关键词: 炎症性肠病, 罗伊适应模式, 饮食, 质性研究, 护理