Abstract:

Objective To explore the real psychological experience of maintenance hemodialysis patients with oral frailty，and to provide a reference for formulating scientific and effective oral care intervention plans. Methods This study adopted a descriptive phenomenological research method. Through purposive sampling and following the principle of maximum variation，patients with oral frailty who underwent maintenance hemodialysis treatment in a tertiary A hospital in Hangzhou from July to August 2025 were recruited as research subjects. In-depth semi-structured interviews were conducted，and Colaizzi seven-step analysis method was used to analyze and organize the interview data. Results 3 core themes and 12 sub-themes were extracted，namely cognition and judgment （conceptual cognitive limitations，risk cognitive desensitization，clear interactional cognition of the disease，delay in severity cognition，attribution bias），motivation and resistance（hierarchical perception of benefits，contradiction in co-morbidity management，exhaustion of energy and time，multi-dimensional external obstacles），behavior and efficacy （lagging healthy behaviors，hierarchical compromise of coping strategies，differentiation of self-efficacy）. Conclusion Maintenance hemodialysis patients have systematic biases in their cognition of oral frailty. Their healthy behaviors are constrained by many factors. A comprehensive intervention system covering systematic early screening mechanisms，multidisciplinary collaborative treatment paths，and individualized behavioral support plans should be constructed to stimulate patients’ internal driving force for health behaviors while strengthening multiple external supports，thereby improving their oral health management ability and quality of life.

Key words: Maintenance Hemodialysis, Oral Frailty, Qualitative Research, Nursing Care

摘要：

目的 探讨维持性血液透析患者对口腔衰弱的真实心理体验，为制订科学有效的口腔护理干预方案提供参考。方法 本研究采用描述性现象学研究方法，通过目的抽样并遵循最大差异化原则，选取2025年7—8月在杭州市某三级甲等医院行维持性血液透析治疗的口腔衰弱患者为研究对象，进行半结构式深度访谈，并运用Colaizzi 7步分析法对访谈资料进行分析与整理。结果 共提炼出3个主题及12个亚主题，分别为认知和判断（概念认知局限、风险认知脱敏、疾病交互认知清晰、严重性认知延迟、归因偏差），动机和阻力（获益感知层级化、共病管理矛盾性、精力与时间耗竭、多维外部阻碍），行为和效能（健康行为滞后、应对策略分级妥协、自我效能分化）。结论 维持性血液透析患者对口腔衰弱的认知存在系统性偏差，其健康行为受诸多因素制约，应构建涵盖系统化早期筛查机制、多学科协作治疗路径及个体化行为支持方案的综合干预体系，在激发患者健康行为内驱力的同时强化多元外部支持，提升其口腔健康管理能力与生活质量。

关键词: 维持性血液透析, 口腔衰弱, 质性研究, 护理