Abstract:

Objective To explore the dynamics of carers’ caregiving dilemmas during different stages of disease progression in patients with diabetic foot ulcers，and to provide a basis for giving precise intervention strategies. Methods Based on the theory of Timing It Right，the phenomenological study was adopted. A purposive sampling method was used to select carers of patients with diabetic foot ulcers who were hospitalised in the Wound Repair Unit of a tertiary hospital in Beijing from March 2023 to February 2024 to conduct semi-structured interviews，and the data were analysed using the Colaizzi 7-step analysis method. Results Combined with the theory of Timing It Right，5 stages of diabetic foot ulcer development were formed，and 5 themes were extracted（①diagnostic period：mixed emotions，facing the dilemma of being unable to do anything；②therapeutic period：lack of knowledge of the disease，and the difficulties of bedside care；③recovery period：contradictions of the desire for rapid healing and the lack of caregiving ability；④transition period：poor patient adherence，and the hope for professional support；⑤adaptation period：the accumulation of negative emotions，and the persistence of caregiving difficulties），and 12 sub-themes. Conclusion At different stages of disease development in patients with diabetic foot ulcers，the caregiving dilemma of caregivers changes dynamically，and healthcare professionals should provide professional，personalised，and high-quality professional support according to their caregiving experience and needs at different stages to improve their quality of care and promote patients’ recovery.

Key words: Diabetic Foot Ulcers, Timing It Right, Carers, Caregiving Dilemmas, Qualitative Research, Nursing Care

摘要：

目的 探讨在糖尿病足溃疡患者疾病发展不同阶段中照护者照护困境的动态变化，为制订精准干预策略提供依据。 方法 基于时机理论，采用现象学研究，选取2023年3月—2024年2月在北京市某三级甲等综合医院创面修复科住院治疗的糖尿病足溃疡患者照护者进行半结构式访谈，运用Colaizzi 7步分析法对资料进行分析。 结果 结合时机理论，形成糖尿病足溃疡发展的5个阶段，提炼出5个主题和12个亚主题。①诊断期：百感交集，面临束手无策的困境。②治疗期：缺乏疾病认知，床旁照护困难重重。③恢复期：渴求快速痊愈与欠缺照护能力矛盾并行。④过渡期：患者依从性差，希望得到专业支持。⑤适应期：负性情绪累积，照护困境持续存在。 结论 在疾病发展不同阶段，糖尿病足溃疡患者照护者的照护困境呈动态变化，医护人员应根据其不同阶段的照护体验和需求，提供个性、优质的专业支持，提高糖尿病足溃疡患者照护者的照护质量，促进患者康复。

关键词: 糖尿病足溃疡, 时机理论, 照护者, 照护困境, 质性研究, 护理