摘要
目的探讨腰椎融合术后患者腰背肌功能锻炼的实施现状,分析影响锻炼的促进及障碍因素,为制定相关干预方案提供理论依据。方法本研究为质性研究。以信息-动机-行为技巧(IMB)模型为理论依据,选取2024年9—11月在首都医科大学附属北京积水潭医院接受腰椎融合术的患者(n=13)、脊柱外科病房医务人员(n=13)和患者家属(n=4)为研究对象进行半结构化访谈。采用Colaizzi 7步分析法对文本资料进行整理、分析和编码。结果提炼出3个主题及14个亚主题,分别为促进因素(康复益处感知、医患信任关系、强烈的康复动机、患者选择偏好);障碍因素(术后残余症状、心理负担、认知缺乏、信息获取受限、不适体验、负性家庭支持);临床实施现状(医护角色定位不清晰、低效型锻炼模式、缺少实施规范与指南、有待建立支持与随访系统)。结论腰椎融合术后患者实施腰背肌功能锻炼受多重促进与障碍因素的影响,医护人员应发挥促进因素,克服障碍因素,采取针对性措施优化患者康复护理实践方案。
ObjectiveTo explore the current status of lumbar paraspinal muscle functional exercise in patients undergoing lumbar fusion surgery,and to analyze the facilitators and barriers affecting these exercises in order to provide a theoretical basis for developing targeted interventions.MethodsThis qualitative study was guided by the Information-Motivation-Behavioral Skills(IMB)model.Semi-structured interviews were conducted between September and November 2024 with 13 postoperative patients,13 medical staff from the spine surgery ward,and four family caregivers at Beijing Jishuitan Hospital,Capital Medical University.Data were orgznized,analyzed and coded using Colaizzi's seven-step method.ResultsA total of three major themes and 14 subthemes were identified.The first major theme highlighted various facilitating factors,including perceived benefits of rehabilitation,a trusting physician-patient relationship,strong motivation for recovery,and patient preference in exercise choices.The second major theme revealed several barriers,including residual postoperative symptoms,psychological burden,lack of awareness,limited access to information,uncomfortable experiences during exercise,and negative family support.The third major theme described the current issues of clinical implementation,including unclear role definitions among healthcare staff,inefficient exercise models,lack of standardized protocols and guidelines,and the need to establish a support and follow-up system.ConclusionsThe implementation of lumbar paraspinal muscle functional exercises post-lumbar fusion surgery is influenced by multiple facilitating and hindering factors.Healthcare professionals should leverage facilitators and overcome barriers by adopting targeted strategies to optimize postoperative rehabilitation care practices.
作者
韩冰
毕宇彤
刘名名
康晓霞
Han Bing;Bi Yutong;Liu Mingming;Kang Xiaoxia(Department of Nursing,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;School of Nursing,Capital Medical University,Beijing 100069,China;Department of Spinal Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)
出处
《中华现代护理杂志》
2025年第17期2254-2261,共8页
Chinese Journal of Modern Nursing
基金
北京市属医院科研培育项目(PX2022017)
北京市医院管理中心临床医学发展专项(YGLX202515)。
关键词
康复护理
腰椎融合术
功能锻炼
腰背肌
质性研究
Rehabilitation nursing
Lumbar fusion surgery
Functional exercise
Lumbar paraspinal muscles
Qualitative study
