摘要
目的 了解慢性便秘患者行肠道菌群移植期间的旅程体验与需求.方法 采用现象学研究方法.采用目的抽样法,选取2023年10-12月上海市第十人民医院肠道微生态诊疗中心行肠道菌群移植的慢性便秘随访患者为受访者进行半结构式访谈.采用Colaizzi 7步分析法,并结合NVivo 11.0软件进行资料分析.结果 共访谈15名受访者.行肠道菌群移植治疗期间,便秘患者旅程地图包含阶段、心情变化、接触点、主题、情感经历及机会点等,其中患者的体验和需求归纳为3个主题与10个副主题.(1)移植前-新环境适应障碍:陌生与迷茫-入院协调障碍、焦虑与期待-多元复杂情绪、困惑与无助-医患信息不对称.(2)移植中-疗效相关联的心理健康社会体验:关注与期待-渴望积极疗效、感知益处和规避风险、羞辱与自卑-治疗污名化体验、质疑与绝望-期望结果未达、治疗抵抗-经济负担敏感.(3)移植后-转归过渡困境:医疗服务不可及-延续性医疗护理缺乏、疾病复发困扰.结论 本研究通过患者旅程地图可视化了便秘患者在行菌群移植治疗期间的经历及体验,并确定了患者多维度的问题与需求.临床医护人员应在制订干预方案时重视患者在治疗过程中不同阶段的需求,以提升肠道菌群移植护理质量.
Abstract
Objective To explore the journey map of patients with chronic constipation during fecal microbiota transplantation.Methods This study adopted phenomenological methods.From October to December 2023,purposive sampling was used to select chronic constipation follow-up patients who underwent fecal microbiota transplantation at the Intestinal Microecology Center of Shanghai Tenth People's Hospital as respondents for semi-structured interviews.Colaizzi 7-step analysis method and NVivo 11.0 software were used for data analysis.Results A total of 15 interviewees were interviewed.During fecal microbiota transplantation,the journey map of constipation patients included stages,mood changes,touchpoints,themes,emotional experiences and opportunities.The patient's experience and needs were summarized into three themes and ten sub-themes,including pre-transplant adaptation disorders to new environments(unfamiliarity and confusion-admission coordination disorders,anxiety and expectations-diverse complex emotions,puzzle and helplessness-asymmetric doctor and patient information),effectiveness-related psychological and social experiences in transplantation(attention and expectations-longing for positive efficacy,perception of benefits and risk avoidance,shame and inferiority-treatment stigmatization experience,questioning and despair-unrealized expectations,treatment resistance-sensitive economic burden),post-transplant transition dilemmas(inaccessible medical services-lack of continuous treatment and nursing,disease recurrence troubles).Conclusions This study visualizes the experiences and needs of constipation patients during microbiota transplantation through a patient journey map and identifies multidimensional issues and needs of patients.Clinical medical and nursing staff should pay attention to the needs of patients at different stages of the treatment process when formulating intervention programs to improve the quality of fecal microbiota transplantation nursing.
维普
万方数据