摘要
目的 探讨减重代谢手术患者术前决策过程中的真实体验,为制订针对性的决策辅助干预策略提供参考依据.方法 本研究为描述性现象学研究.采用目的抽样法,选取2022年9月—2023年2月在浙江大学医学院附属邵逸夫医院接受减重代谢手术的21例患者进行访谈,采用Colaizzi 7步法进行资料分析.结果 最终提炼出4个主题和14个亚主题:决策动机(健康受到威胁、追求更高的生活质量、自尊心受损、家庭责任驱动);决策前评估(其他减重方式失败、手术是最后的机会);决策困境(可获取的信息质量低、社会对手术的认可度低、医疗保险缺位、担忧手术结果);决策支持(医疗专业支持、家庭支持、同伴支持、自我支持).结论 减重代谢手术患者术前决策动机各异,且面临决策困境,建议相关部门、医护人员及亲友共同努力,从患者角度出发,为减重代谢手术患者构建全方位的决策支持性环境.
Abstract
Objective To explore the real experiences of patients during the preoperative decision-making process for metabolic-bariatric surgery,providing a reference for developing targeted decision-support interventions.Methods This descriptive phenomenological study used purposive sampling to select 21 patients who underwent metabolic-bariatric surgery at Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine,from September 2022 to February 2023.Interviews were conducted,and the data were analyzed using Colaizzi's seven-step method.Results Four themes and 14 sub-themes were extracted:decision-making motivation(health threats,pursuit of higher quality of life,diminished self-esteem,family responsibility drive);pre-decision assessment(failure of other weight-loss methods,surgery as a last resort);decision-making dilemmas(low quality of accessible information,low social acceptance of surgery,lack of medical insurance coverage,concerns about surgical outcomes);and decision-making support(professional medical support,family support,peer support,self-support).Conclusions Patients considering metabolic-bariatric surgery have diverse decision-making motivations and face significant dilemmas.It is recommended that relevant authorities,healthcare providers,and family members work together to create a comprehensive decision-supportive environment from the patients'perspective.
维普
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