基于二级预防的冠心病患者患病体验的现象学研究

发布时间：2018-03-14 14:47

本文选题：冠心病　切入点：患病体验　出处：《河北大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究从冠心病患者角度出发,了解患者在长期带病生存状态下对冠心病的生理、心理、医患互动及需求等方面的真实体验,探索冠心病患者患病体验对二级预防的影响。以期得出有意义的结论,优化冠心病二级预防实施策略,为提高冠心病患者二级预防依从性提供依据。方法:本研究采用质性研究中现象学的研究方法,通过目的抽样选取某三甲医院心内科病房的11位冠心病患者,依据事先制定的访谈提纲进行一对一半结构式深入访谈,对访谈资料进行转录后,采用Colaizzi分析方法对资料进行整理和分析,提取主题。结果:本研究共提取5个主题,每个主题有包含若干次主题:主题一:对疾病的认知不足包含次主题为:对首发症状的感知不敏感、对病情的不以为然心理、症状减轻时的盲目乐观、医生病情交代的策略性、无效的健康宣教。主题二:病情加重后的态度转变包含次主题为:饱受病情反复的生理折磨、疾病反复的无奈心理、他人不良事件带来的冲击、疾病复发后重视程度的提高、长期带病患者的心态趋于平和。主题三:自行调整药物包含次主题为:症状减轻后自行停药、非专业人员更改药物、对药物副作用的担忧、药物信息及目的不明确。主题四:不良习惯纠正的困难包含次主题为:长期养成的不良习惯不易纠正、外在环境诱惑与内在动力不足。主题五:对专业人员疾病教育的期待包含次主题为:疾病相关知识的需求、出院后定期针对性的随访、健康教育规范化。结论:1.冠心病患者的生理及心理体验均会影响其对冠心病二级预防的重视和依从程度,医务工作者应关注患者的患病体验,制定个体化的二级预防实施策略。2.医患沟通对冠心病患者对待疾病的态度及二级预防意识起到关键性作用,医护人员需要讲究沟通技巧,避免患者对疾病产生误解。3.冠心病患者在执行二级预防药物及非药物措施中存在误区及困难,医护人员需要做好预测和防范,以提高患者的依从性。4.冠心病患者对疾病的相关知识、健康宣教及院外随访有所需求,医护人员应开展相关工作内容。
[Abstract]:Objective: This study from the perspective of patients with coronary heart disease, to understand the mental patients in physiology, long-term survival in patients with coronary heart disease state, doctor-patient interaction and demand, the real experience of patients with coronary heart disease, explore the prevalence of the experience of two grade prevention. In order to draw meaningful conclusions, optimization of coronary heart disease in two primary prevention strategies for improve the coronary heart disease patients with two grade prevention compliance basis. Methods: This study adopts the research methods of phenomenology in qualitative research, selected 11 patients with coronary heart disease in Department of cardiology ward in a hospital by purposive sampling, in-depth interviews of a semi-structured interview outline based on pre established, the transcription of the interview data, the Colaizzi analysis of the data collection and analysis, extraction of the subject. Results: This study extracted a total of 5 themes, each theme contains several themes: theme: The lack of knowledge of disease including the theme: the first symptom is not sensitive to the perception of psychological, not to regard it as right of the disease, symptoms of blind optimism, strategic doctor explained, ineffective health education. Two themes: change after illness attitude including the theme: the physiological disease repeatedly tortured. Recurrent disease helpless psychology, other adverse events impact disease recurrence after increased emphasis, patients with long-term sick mentality tend to be peaceful. Theme three: adjust the drug containing theme is: reducing the symptoms after their withdrawal, non professional personnel to change the drugs, the side effects of the drugs concerns, drug information and the purpose is not clear. The four theme: bad habits to correct the difficulties including the topic: long habit is not easy to correct bad habits, lack of external environment and internal power. Temptation theme five: the professional personnel The disease education theme is expected to contain: the disease related knowledge needs after discharge for regular follow-up, standardized health education. Conclusion: the physiological and psychological experience of 1. patients with coronary heart disease will affect on the two grade prevention of coronary heart disease and the importance of the degree of compliance, medical workers should pay attention to psychological experience of patients, develop two individual preventive.2. implementation strategy of doctor-patient communication and two grade prevention to treat disease in patients with coronary heart disease awareness plays a key role, health care workers need to pay attention to communication skills, to avoid misunderstanding of.3. in patients with coronary heart disease patients with misunderstandings and difficulties in the implementation of the two grade prevention of drug and non drug measures of disease, health staff good prediction and prevention, in order to improve the knowledge of.4. compliance in patients with coronary heart disease in patients with the disease, health education and hospital follow-up has needs, medical personnel should be open Exhibition related work.

【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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