直肠癌临时性回肠造口患者居家生活体验的质性研究

周强; 张晓双; 孙琳; 郭坤; 王茜; 沈旻静; 王家成; 袁丽; 方浩男

doi:10.16766/j.cnki.issn.1674-4152.004467

直肠癌临时性回肠造口患者居家生活体验的质性研究

doi: 10.16766/j.cnki.issn.1674-4152.004467

周强¹,
张晓双¹,
孙琳^2, ,,
郭坤²,
王茜¹,
沈旻静²,
王家成²,
袁丽³,
方浩男¹

1.
蚌埠医科大学护理学院, 安徽蚌埠 233030
2.
中国科学技术大学附属第一医院(安徽省立医院)普外科结直肠外科, 安徽合肥 230001
3.
中国科学技术大学附属第一医院(安徽省立医院)肝移植科

基金项目:

2023年度安徽省高校自然科学研究项目 2023AH05

详细信息

通讯作者:
孙琳，E-mail：sunlin0129@126.com

中图分类号: R735.37
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出版历程
- 收稿日期: 2025-03-17

Home life experience in patients with temporary ileostomy for rectal cancer: A qualitative study

1.
College of Nursing, Bengbu Medical University, Bengbu, Anhui 233030, China

摘要

摘要: 目的探索直肠癌临时性回肠造口患者居家生活体验情况，为临床医护人员制定此类患者居家护理计划提供参考。方法采用目的抽样法，选取2023年12月—2024年10月在中国科学技术大学附属第一医院(安徽省立医院)就诊的直肠癌保留临时性回肠造口患者作为研究对象，并对其进行半结构化访谈，最终访谈15例患者。访谈提纲在文献回顾、课题组讨论和对2例患者进行预访谈的基础上制定，研究者在访谈时对访谈内容进行录音，在访谈结束后24 h内，由2名研究者将访谈录音转录成文字，采用Colaizzi 7步分析法对访谈内容进行分析并归纳主题。结果直肠癌临时性回肠造口患者居家生活体验可提炼出4个主题：(1)生活行为改变(睡眠质量降低、饮食的转变、体力活动不足)；(2)复杂的情感(无奈地接受疾病、积极地调整心态、勇敢地面对疾病)；(3)居家生活困难(出现造口并发症、缺乏自我护理能力、经济负担重)；(4)居家生活需求(需要延续性护理服务、希望进行造口还纳)。结论直肠癌临时性回肠造口患者居家生活体验丰富，患者存在勇敢面对疾病的积极体验，但也存在睡眠、饮食、造口并发症、经济负担重和存在延续性护理需求等消极体验。医护人员要关注居家生活患者的消极体验，联合家庭、地方政府和社会多方力量，提供多方位的支持，从而提高患者居家生活的质量。
- 直肠癌 /
- 临时性回肠造口 /
- 居家生活体验 /
- 质性研究
Abstract: Objective To explore the home-living experiences of patients with rectal cancer with a temporary ileostomy, and to provide a reference for clinical healthcare professionals in developing home-care plans for such patients. Methods Purposive sampling was used to recruit patients with rectal cancer who retained a temporary ileostomy and were treated at the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital) between December 2023 and October 2024, and semi-structured interviews were conducted with 15 patients. The interview guide was developed on the basis of a literature review, project-group discussions, and pilot interviews with two patients, interviews were audio-recorded, and within 24 h after each interview two researchers transcribed the recordings into text and analyzed the interview content using Colizzi ' s seven-step method to synthesize themes. Results The home-living experiences of patients with rectal cancer and a temporary ileostomy were distilled into four themes: (1) changes in living behaviors (reduced sleep quality, dietary changes, and insufficient physical activity); (2) complex emotions (reluctant acceptance of the illness, positive psychological adjustment, and courageous confrontation of the illness); (3) difficulties in home life (stoma-related complications, lack of self-care ability, and heavy financial burden); (4) needs in home life (need for continuity of care services and hope for stoma reversal). Conclusion The home-living experiences of patients with rectal cancer with a temporary ileostomy are rich, patients have positive experiences of courageously facing the illness, but also negative experiences such as problems with sleep and diet, stoma-related complications, a heavy financial burden, and needs for continuity of care. Healthcare professionals should attend to these negative experiences in home-dwelling patients. By collaborating with families, local government, and society resources, they can provide multidimensional support to improve the quality of patients ' home life.
- Rectal cancer /
- Temporary enterostomy /
- Home life experience /
- Qualitative research
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HTML全文

表 1 15例直肠癌患者一般资料

Table 1. General characteristics of 15 patients with rectal cancer

编号	性别	年龄(岁)	文化程度	职业	婚姻状况	居住地	放/化疗	术后时间(月)	照顾者
P1	男	70	高中	公务员(退休)	已婚	城市	化疗	3	配偶
P2	女	71	高中	营业员(退休)	已婚	城市	无	4	子女
P3	男	66	小学	农民	丧偶	农村	化疗	5	子女
P4	女	54	初中	个体经营	已婚	城市	无	6	配偶
P5	女	58	初中	职员(退休)	已婚	城镇	放疗	5	子女
P6	男	71	小学	铁路司机(退休)	已婚	城市	放疗	7	子女
P7	女	57	小学	农民	已婚	农村	化疗	6	子女
P8	男	66	文盲	农民	已婚	农村	无	3	子女、配偶
P9	男	54	初中	无业	已婚	城市	放疗	3	配偶
P10	女	56	高中	银行职员(退休)	已婚	城镇	放疗、化疗	1	无
P11	男	52	初中	自由职业	已婚	城市	放疗	1	配偶
P12	男	57	初中	农民	已婚	城市	化疗	4	配偶
P13	女	57	初中	矿工(退休)	已婚	农村	化疗	7	配偶
P14	男	60	小学	农民	已婚	城市	无	2	配偶
P15	女	61	高中	工人(退休)	已婚	城市	无	3	配偶

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