老年共病患者心理危机自我表露阻碍和促进因素的质性研究

目的 深入探究老年共病患者心理危机表露的阻碍和促进因素，为促进老年患者面临心理危机时的自我表露提供依据。方法 采用现象学研究方法，访谈14例老年共病患者。结果 阻碍因素包括个人因素(内向/隐忍型性格、担心给家人带来困扰、对生命状态的负性心理)和动机因素(消极反馈、认知缺乏、时间弱化),促进因素包括感知表露后益处、良好的支持系统、个人表达意愿强。结论 老年共病患者心理危机表露存在阻碍和促进因素，应通过让患者感知表露后益处、给予良好的支持系统、丰富多种表露途径、加强患者对心理危机的认知等措施来促进老年共病患者主动表露其心理危机。

A qualitative study of impediments and facilitators to self-expression of psychological crisis in the elderly multimorbidity

Objective To explore the obstacles and facilitators of psychological crisis disclosure in elderly patients with multimorbidity, in order to provide a basis for the promotion of self-expression of psychological crisis in elderly patients.Methods A phenomenological research method was used to interview 14 elderly co-morbid patients.Results Obstructive factors included personal factors （introverted/stoic personality, fear of distressing family members, and negative psychology about the state of life） and motivatio-nal factors （negative feedback, lack of cognition, and temporal weakness）.Facilitating factors included perceived benefits of disclosure, good support systems, and a strong willingness to express oneself.Conclusion There are obstacles and facilitators to the disclosure of psychological crisis in elderly co-morbid patients. We should promote elderly co-morbid patients′ active disclosure of their psychological crisis through measures such as letting patients perceive the post-disclosure benefits, providing a good support system, enriching a variety of channels of disclosure, and strengthening the patients′ cognition of psychological crisis.