肿瘤患者手术后重症监护室不适感体验的质性研究.doc

肿瘤患者手术后重症监护室不适感体验的质性研究 顾婷 刘静 王丽英 刘玉华 （复旦大学附属肿瘤医院护理部，复旦大学上海医学院肿瘤学系，上海 200032） 作者简介：顾婷（1981—），女，主管护师，主要从事肿瘤ICU护理及管理。 通讯作者：刘玉华（1983—），女，主管护师，主要从事肿瘤ICU临床护理工作。 【摘要】 目的 深入了解和探索ICU肿瘤患者不舒适体验及相关影响因素并提出改进方法。 方法 采用质性研究的方法，通过对入住ICU的10例肿瘤患者进行深入访谈，对资料进行细致的分析和推理，寻找与探索ICU患者不适体验的共性和个性部分，并对其所代表的人群进行归纳总结。 结果 入住ICU的患者心理和生理承受着巨大的压力，可导致其产生不适体验。主要包括对自身疾病的不确定感、个人时间及活动范围的受限以及多种生理不适感，如疼痛、口干及睡眠障碍以及治疗费用的忧虑等因素。对部分因素进行相关干预可能改善患者的不适体验。 结论 需要多元整体护理方法，从环境改善、心理护理、生理护理等多元护理方法减轻肿瘤患者术后重症监护室不适感体验。 【关键词】 不适感；质性研究； 重症监护室； 恶性肿瘤；危险因素 Perception of Stressors in Patients with Malignant tumors in Intensive Care Unit and Qualitative Study of Risk Factors（Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China） Ting Gu ， Jing Liu ， Liying Wang ， Yuhua Liu . Abstract: Purpose: To explore the perception of stressors in patients with malignant tumors in intensive care unit (ICU) and its risk factors. Materials and Methods: A total of 10 patients with malignant tumors were interviewed with a structured interview guide. The qualitative study design was used to analyze the general characteristics and individuality of the patients, and to explore the risk factors for perception of stressors in ICU. Results: The perception of stressors was distinct in patients with malignant tumors in ICU. Multiple factors attributed to this disorder, including uncertainty of outcomes, deprivation of personal time, limited activity, being thirsty, being in pain, not able to sleep and hearing the buzzers, and medical cost. Interventions for these factors may improve patients’ perception of stress in ICU. Conclusions：The findings suggest that nurses must utilize more effective communication techniques and interventions to relieve patients’ pain, and provide an atmosphere in which rest is possible, with less light, noise, and the fewest possible interruptions. Key Words: Perception of Stressors; Qualitative St