强直性脊柱炎患者围手术期的心理体验及应对的质性研究

目的:探讨强直性脊柱炎患者从入院到术后三个月间的心理体验及应对。方法：采用质性研究中的现象学研究法对12例强直性脊柱炎患者进行半结构式访谈,采用Colaizzi分析法处理资料。结果：按照时间阶段提取出强直性脊柱炎患者围手术期心理体验及应对的四大主题:1.疾病日渐进展,疾病信息支持不足,入院后对做出手术的决策犹豫不决及紧张焦虑；2.手术过程中的煎熬与自我舒缓,手术后躯体症状问题突出,对预后的困惑与期待医患沟通；3.出院前心理问题突出,对医生护士的感恩以及对出院后生活的迷茫；4.出院后,居家照护支持不足,对康复锻炼的努力尝试以及对社会功能尽快恢复的无限向往。结论:强直性脊柱炎患者在围手术期的心理体验及其应对呈阶段性和动态变化,医护人员应根据研究结果提供个体化服务,给予治疗照护、心理、信息等多维度的支持,并保障院外护理的延续性,从而促进患者身心全面康复。

Qualitative Research on the Perioperative Psychological Experience and Response of patients with Ankylosing Spondylitis

Objective: To investigate the psychological experience and coping measures of patients with ankylosing spondylitis from admission into hospital to three months after operation. Methods: A semi-structured interview with 12 patients with ankylosing spondylitis was conducted using the phenomenological methods in qualitative research. Colaizzi analysis was used to process the data. Results: During the time period, four main topics about perioperative psychological experience and response of patients with ankylosing spondylitis were extracted: 1.After admission, patients are hesitant and anxious to make decisions on whether to receive the operation due to disease progression and insufficient information. 2.Suffering during perioperative period was caused by uncertainty of disease prognosis.Detailed and clear communication was needed between surgeons and patients. 3.Psychological problems on discharge. The patients are thankful for the doctors and nurses, but confused about their life afterwards. 4.After leaving the hospital, patients make efforts to rehabilitate and have endless aspiration toward social recovery as soon as possible, despite the lack of support for home care. Conclusion: The perioperative psychological experience and response of patients with ankylosing spondylitis has stepwise and dynamic changes. In order to promote the full rehabilitation of patients from physical and mental aspects, doctors and nurses should design individualized services based on the results of this study, provide multi-dimensional support and protection including treatment care, psychological support, and information support, and ensure the continuation of hospital care.