Abstract:

Objective To understand the real-life experiences of patients with chronic obstructive pulmonary disease（COPD） in disease self-control and to inform clinical nursing practice. Methods From March to May 2024，a phenomenological research method was used to conduct semi-structured interviews with 15 patients with COPD who were either outpatients or inpatients in a tertiary hospital in Suzhou City，China，and the data were analyzed using the Colaizzi 7-step analysis method. Results Totally 3 themes and 9 sub-themes were extracted，namely self-control challenges due to cognitive deficits（lack of knowledge leads to ambiguous control direction；cognitive bias hinders control strategy formulation；negative perception leads to control avoidance），weakening trend of self-control behaviors（decision-making conflicts between immediate indulgence and delayed gratification；lack of reinforcement mechanisms leads to psycho-emotional depletion；external temptations lead the self to imitate bad behavior），urgent need for multiple supports to help with self-control（the desire for continuity and stability of family support，the need for professionalism and accuracy of healthcare guidance，and the expectation for rationality and matching of resource allocation）. Conclusion Healthcare professionals should pay attention to the real experience of COPD patients in the process of disease self-control，help them effectively deal with the challenges of disease self-control，strengthen self-control behaviors，and satisfy their diversified needs by strengthening the support of families，professionals，and the community to improve poor outcomes and reduce the cost of healthcare services.

Key words: Pulmonary Disease, Chronic Obstructive, Self-Control, Disease Management, Qualitative Research, Nursing Care, Experience

摘要：

目的 了解慢性阻塞性肺疾病患者疾病自我控制的真实体验，为临床护理实践提供参考。 方法 2024年3月—5月，采用现象学研究方法，对苏州市某三级甲等医院门诊或住院的15例慢性阻塞性肺疾病患者进行半结构式访谈，采用Colaizzi 7步分析法进行资料分析。 结果 提炼出3个主题和9个亚主题，即面临认知不足下的自我控制挑战（知识缺乏导致控制方向模糊、认知偏差阻碍控制策略制订、消极感知造成控制选择回避）、自我控制行为出现弱化趋势（存在即时放纵与延迟满足的决策冲突、强化机制缺失引发心理情感损耗、外界诱惑引导自我不良行为模仿）、亟需多方助力以提升自我控制（对家庭支持的持续性与稳定性的渴望、对医护指导的专业性与个性化的需求、对资源配置的合理性与匹配度的期待）。 结论 医护人员应重视慢性阻塞性肺疾病患者疾病自我控制过程中的真实体验，帮助其有效应对疾病自我控制挑战，强化自我控制行为，通过加强家庭、专业人员及社会等多方支持，满足其多样化需求，改善不良结局，降低医疗服务成本。

关键词: 肺疾病, 慢性阻塞性, 自我控制, 疾病管理, 质性研究, 护理, 体验