间质性肺疾病患者居家肺康复行为影响因素的质性研究

许文锦; 王清; 代静泓; 苗桂玲; 高莉; 杨文芬

doi:10.16766/j.cnki.issn.1674-4152.004362

间质性肺疾病患者居家肺康复行为影响因素的质性研究

doi: 10.16766/j.cnki.issn.1674-4152.004362

1.
南京大学医学院附属鼓楼医院呼吸与危重症医学科，江苏南京 210015
2.
南京大学医学院附属鼓楼医院护理部

基金项目:

国家自然科学基金项目 82170076

江苏省老年健康科研项目 LKM2023024

详细信息

通讯作者:
王清，E-mail：ruoyiwangqing@163.com

中图分类号: R563 R492
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- 文章访问数: 2
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- 被引次数: 0
出版历程
- 收稿日期: 2025-08-24
- 网络出版日期: 2026-04-11

A qualitative study of factors influencing pulmonary rehabilitation in patients with interstitial lung disease at home

1.
Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu 210015, China

摘要

摘要: 目的从患者主观体验出发，深入了解间质性肺疾病患者居家肺康复行为的障碍与促进条件，为制订有效的居家肺康复方案提供理论支撑和实践指导。方法基于计划行为理论，通过目的抽样，运用描述性质性研究，对2024年9—12月在南京大学医学院附属鼓楼医院有居家肺康复经历的15例间质性肺疾病患者进行半结构式访谈。基于文献回顾、课题组讨论、预访谈，拟订访谈提纲，对访谈过程进行录音，采用MAXQDA 2022软件进行资料管理分析，采用内容分析法分析资料。结果共提炼出3个主题，10个亚主题，分别为行为态度因素(感知康复益处、运动恐惧、消极康复期望、康复方案偏好)；主观规范因素(正向情感反馈激励康复行为、社会角色压力与责任驱动的“博弈”、医务人员积极态度的驱动效应)；感知行为控制因素(不良躯体症状、康复资源获取受阻、康复环境支持不足等)。结论间质性肺疾病患者的居家肺康复行为受到行为态度、主观规范和感知行为控制因素的多重影响，医护人员应从患者角度出发，结合行为态度、家庭与社会支持、感知康复难易程度的因素全面考虑，增强间质性肺疾病患者康复价值感知，促进患者树立积极行为态度，完善多元支持系统，减少患者参与康复行为的阻碍因素，为患者提供个性化、全面化、动态调整的肺康复方案。
- 间质性肺疾病 /
- 居家肺康复 /
- 影响因素 /
- 质性研究
Abstract: Objective To deeply understand the obstacles and promoting conditions of home-based pulmonary rehabilitation behaviors of patients with interstitial lung disease from the subjective experience of patients, and to provide theoretical support and practical guidance for formulating effective home-based pulmonary rehabilitation plans. Methods Based on the theory of planned behavior, through purposeful sampling and descriptive qualitative research, semi-structured interviews were conducted with 15 patients with interstitial lung disease who had home-based pulmonary rehabilitation experience in a tertiary grade A hospital in Nanjing from September to December 2024. Based on literature review, discussion within the research group, and pre-interviews, an interview outline was drafted. The interview process was recorded. MAXQDA 2022 software was used for data management and analysis, and content analysis was adopted to analyze the data. Results A total of 3 themes and 10 sub-themes were extracted, namely behavioral attitude factors (perceived rehabilitation benefits, fear of movement, negative rehabilitation expectations, and preference for rehabilitation programs), subjective normative factors (positive emotional feedback to motivate rehabilitation behaviors, the "game" driven by social role pressure and responsibility, and the driving effect of positive attitudes of medical staff), and perceived behavioral control factors (adverse physical symptoms, blocked access to rehabilitation resources, insufficient support from the rehabilitation environment). Conclusion The home-based pulmonary rehabilitation behavior of patients with interstitial lung disease is influenced by multiple factors such as behavioral attitude, subjective norms, and perceived behavioral control factors. Medical staff should start from the perspective of patients, comprehensively consider factors such as behavioral attitude, family and social support, and perceived difficulty of rehabilitation, enhance the perceived rehabilitation value of patients with interstitial lung disease, and promote patients to establish a positive behavioral attitude, improve the multi-faceted support system, and reduce the hindering factors for patients to participate in rehabilitation behaviors, providing patients with personalized, comprehensive and dynamically adjusted pulmonary rehabilitation plans.
- Interstitial lung disease /
- Home pulmonary rehabilitation /
- Influencing factor /
- Qualitative study

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表 1 15例受访者的一般资料

Table 1. General information of 15 participants

编号	年龄(岁)	性别	婚姻状况	学历	疾病类型	mMRC分级
N1	61	男性	已婚	高中	特发性肺纤维化	1
N2	52	男性	已婚	初中	特发性肺纤维化	1
N3	70	男性	已婚	小学	特发性肺纤维化	1
N4	61	女性	已婚	中专	肺结节病	1
N5	46	男性	已婚	初中	特发性肺纤维化	1
N6	71	男性	已婚	高中	特发性肺纤维化	2
N7	77	男性	已婚	大学	特发性肺纤维化	4
N8	79	男性	已婚	初中	特发性肺纤维化	4
N9	40	女性	已婚	初中	免疫相关性ILD	1
N10	72	女性	已婚	文盲	系统性硬化病继发ILD	1
N11	61	女性	离异	初中	类风湿性关节炎继发ILD	0
N12	28	女性	已婚	大学	机化性肺炎	1
N13	56	女性	已婚	大学	血管炎相关性ILD	1
N14	67	女性	已婚	中专	免疫相关性ILD	1
N15	55	女性	已婚	初中	免疫相关性ILD	2

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