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椎管内肿瘤切除术后恐动患者早期躯体活动体验的质性研究

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目的 了解椎管内肿瘤切除术后恐动症患者躯体活动的心理体验,为促进患者术后康复提供参考.方法 采用目的抽样法,选取2023年6-8月于沈阳市2所三级甲等综合医院神经外科行椎管内肿瘤切除术且术后伴有恐动症的14例患者进行半结构式访谈,采用Colaizzi七步分析法对访谈资料进行分析、归纳及提炼主题.结果 椎管内肿瘤切除术后恐动患者对于术后早期躯体活动的体验可以归纳为4个主题:躯体活动参与度低(运动自我效能感低、躯体活动量不足),相关症状影响术后活动(疼痛应激反应敏感、麻木症状影响术后活动信念),术后心理压力大(担心早期躯体活动影响预后、经济负担较重、负性心理反应、留置导管引起的心理障碍),缺乏专业指导(专业指导信息不全面、动态评估不及时、医护人员的宣教指导存在差异).结论 椎管内肿瘤术后患者因多种身心因素影响易产生恐动心理,医护人员应及时评估,并制订针对性干预方案,以提高患者对躯体活动的认知水平,促进患者术后康复.
Qualitative Study on Experiences in Early Physical Activities Among Patients with Kinesiophobia After Intraspinal Tumor Resection
Objective To understand the psychological experiences in physical activities among patients with kinetophobia after intraspinal tumor resection,aiming to provide a reference for accelerating postoperative rehabilitation.Methods From June to August 2023,14 patients with postoperative kinetophobia were selected by purposive sampling who underwent intraspinal tumor resection at the neurosurgery department in one of the two Grade Ⅲ-A general hospitals in Shenyang.They received semi-structured interviews.Their interview data were analyzed,summarized and refined using Colaizzi's seven-step method.Results For these patients with kinetophobia after intraspinal tumor resection,the following 4 topics were extracted regarding their experiences in early postoperative physical activities:1)Low participation in physical activities—low exercise self-efficacy and insufficient physical activity;2)affected postoperative activities due to related symptoms—stress response and sensitivity to pains,and affected postoperative activity-related beliefs due to numbness symptoms;3)high postoperative psychological pressure—worries about the impact of early physical activities on prognosis,heavy economic burden,negative psychology,and psychological disorders caused by indwelling catheters;4)lack of professional guidance—incomplete professional guidance information,untimely dynamic assessment,and inconsistent education from healthcare providers).Conclusion Patients who have undergone intraspinal tumor resection are susceptible to kinetophobia due to a variety of physical and mental factors.Healthcare providers should make timely assessments and develop targeted interventions to improve their understanding of physical activities and accelerate postoperative rehabilitation.

Intraspinal tumorSurgeryKinetopho-biaPhysical activityInterviewQualitative study

方奎、朱晨、张晶、李光宇、刘琰、余立平

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武汉大学护理学院,湖北 武汉 430062

中国医科大学附属第一医院,辽宁 沈阳 110001

椎管内肿瘤 手术 恐动症 躯体活动 访谈 质性研究

国家自然青年科学基金项目

82103450

2024

上海护理
上海市护理学会

上海护理

影响因子:1.097
ISSN:1009-8399
年,卷(期):2024.24(10)
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