Facilitators and impediments to home glucose management for patients undergoing bariatric surgery: a qualitative study
张笑倩 1姚琳 1王金凤 1刘春霞 1朱丽华 1段晓旭1
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作者信息
1. 中日友好医院普外科·代谢减重中心，北京 100029
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摘要
目的 基于实施性研究综合框架（CFIR）探讨减重术后患者居家血糖管理的促进和阻碍因素，为减重术后血糖管理路径的制订提供参考依据。 方法 本研究为描述性现象学研究。采用目的抽样法，于2023年11月—2024年1月选取中日友好医院普外科·代谢减重中心的7名医护人员和11例减重术后患者为研究对象，进行半结构化访谈，采用定向内容分析法进行资料分析。 结果 共提炼出与CFIR 5个维度相关的6个促进因素和6个阻碍因素。促进因素包括个性化血糖管理方案、长期规律性随访、多学科管理团队、亲友支持、并发症困扰和信息化平台；阻碍因素包括随访模式化、资源的可及性与便捷性差、角色冲突、从众心理、行为依从性欠佳、数字化设备使用率低。 结论 减重术后患者血糖管理需求不同，管理依从性逐渐下降。医护人员应构建"互联网+"居家血糖管理服务模式，开展针对性的多学科团队随访，促进患者居家血糖管理规范化路径的形成。 Objective To explore facilitators and impediments to home glucose management for patients undergoing bariatric surgery based on the consolidated framework for implementation research (CFIR), so as to inform the development of a glucose management pathway after bariatric surgery. Methods This study was a descriptive phenomenological study. Using purposive sampling method, seven healthcare professionals and 11 patients undergoing bariatric surgery from the General Surgery·Metabolic and Bariatric Center of China-Japan Friendship Hospital were selected from November 2023 to January 2024 for semi-structured interviews. Targeted content analysis was used for the data analysis. Results A total of six facilitators and six impediments related to the five dimensions of CFIR were distilled. Facilitators included the personalized glucose management program, regular long-term follow-up, multidisciplinary management team, support from family and friends, complication distress, and information technology platform. Impediments involved patterned follow-up, poor accessibility and convenience of resources, role conflict, herd mentality, poor behavioral compliance, and low utilization of digital equipment. Conclusions Glucose management needs vary in patients after bariatric surgery, with a gradual decline in management compliance. Healthcare professionals should build an "Internet +"home glucose management service model, carry out targeted multidisciplinary team follow-up, and promote the formation of a standardized pathway for patients' home glucose management.
Abstract
Objective To explore facilitators and impediments to home glucose management for patients undergoing bariatric surgery based on the consolidated framework for implementation research (CFIR), so as to inform the development of a glucose management pathway after bariatric surgery. Methods This study was a descriptive phenomenological study. Using purposive sampling method, seven healthcare professionals and 11 patients undergoing bariatric surgery from the General Surgery·Metabolic and Bariatric Center of China-Japan Friendship Hospital were selected from November 2023 to January 2024 for semi-structured interviews. Targeted content analysis was used for the data analysis. Results A total of six facilitators and six impediments related to the five dimensions of CFIR were distilled. Facilitators included the personalized glucose management program, regular long-term follow-up, multidisciplinary management team, support from family and friends, complication distress, and information technology platform. Impediments involved patterned follow-up, poor accessibility and convenience of resources, role conflict, herd mentality, poor behavioral compliance, and low utilization of digital equipment. Conclusions Glucose management needs vary in patients after bariatric surgery, with a gradual decline in management compliance. Healthcare professionals should build an "Internet +"home glucose management service model, carry out targeted multidisciplinary team follow-up, and promote the formation of a standardized pathway for patients' home glucose management.
关键词
质性研究/减重代谢术/居家康复/血糖管理/实施性研究综合框架
Key words
Qualitative research/Bariatric surgery/Home rehabilitation/Glucose management/Consolidated framework for implementation research
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