目的 探究增生型糖尿病视网膜病变患者硅油填充期间的体验与应对行为,为制定个性化的干预措施提供依据。 方法 基于自我调节常识模型制定访谈提纲。采用目的抽样法,对2024年2—4月河南省某三级甲等医院眼底外科收治的15例行硅油填充术的PDR患者进行深入访谈,采用Colaizzi 7步分析法进行主题的归纳与分析。 结果 共归纳出4个主题,9个亚主题：光明之困,视力下降导致生活质量降低（日常生活受限、受伤风险增加、术后保持特定体位带来的不适）;情绪之重,疾病感知加重负性情绪体验（紧张、焦虑与担忧;沮丧、孤独与边缘化;后悔与自责）;支持之需,缺乏并渴望理解与支持;应对之策,疾病认知与感知决定应对方式（情绪中心型、问题中心型、回避/屈服型应对方式）。 结论 PDR患者硅油填充期间面临视力下降和情绪困扰的双重挑战,渴望得到更多的照顾与支持,其应对方式与患者的疾病认知和感知有关。护理人员应当重视PDR患者硅油填充期间的疾病体验,满足PDR患者多样化的支持需求并引导其采取积极的应对策略来治疗和管理疾病,帮助患者延缓疾病进展、促进身心健康,增强积极应对。
Abstract
Objective To explore the experiences and coping styles during silicone oil filling in patients with proliferative diabetic retinopathy (PDR), and to provide reference for developing personalized intervention strategies. Methods An interview outline based on the Common Sense Model of self-regulation was formulated. Purposive sampling was used to select 15 PDR patients with silicone oil filling at the retina department in one tertiary grade-A hospital in Henan Province. In-depth interviews were conducted in these 15 patients from February to April 2024. The data were analyzed using Colaizzi's seven-step method. Results Four themes and nine sub-themes were identified including plight of vision: vision loss leading to a decrease in quality of life due to the difficulty of seeing clearly (restrictions in daily life, increased injury risks, discomfort from specific position after operation); emotional burden: increased negative emotions from disease perception (anxiety, worry, frustration, loneliness, and regret); support needs: lack of and desire for understanding and support; coping strategies: coping styles influenced by illness perceptions (emotion-focused coping style, problem-focused coping style, avoidance/submission). Conclusion PDR patients during silicone oil filling confront vision loss and emotional distress, seeking more care and support. Their coping styles are related to disease cognition and perceptions. Nurses should address these challenges through tailored support. Effective coping strategies for disease management are conductive to potentially slowing progression and improving well-being.
关键词
糖尿病视网膜病变 /
硅油填充 /
疾病体验 /
质性研究
Key words
diabetic retinopathy /
silicone oil filling /
disease experience /
qualitative research
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参考文献
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基金
河南省医学科技攻关计划项目基金资助项目（LHGJ20210071）
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