内镜黏膜下剥离术后使用自控式水囊体验的质性研究

Qualitative Study on the Experience of Using a Self Controlled Water Balloon after Endoscopic Submucosal Dissection

摘要: 目的：描述内镜黏膜下剥离术(ESD)后使用自控式水囊的体验，旨在为该人群护理提供参考依据。方法：采用田野式访谈，按照目的抽样法，于2024.01~2024.06选取在上海市东方医院内镜中心内镜黏膜下剥离术后复诊治疗50例患者进行访谈，并以内容分析法归纳和提炼主题。结果：提炼出5个主题及11个亚主题；生理不适感(身体层面不适感、迫切渴望拔除气囊)、心理不适感(病耻感、焦虑)、生活质量下降(生活习惯改变、睡眠质量降低)、期待社会支持(期待理解和尊重、依赖家庭支持、渴望社会支持)、疾病自我管理能力不足(预后的认知较差、水囊使用依从性)。结论：内镜黏膜下剥离术后使用自控式水囊的患者除了对疾病焦虑外，对于水囊的使用、使用注意事项以及过程中的各种支持仍有较高的需求。未来应制定多方位干预措施，促进其更好地疾病康复、尽快恢复正常生活。

Abstract: Objective: To describe the experience of using a self controlled water balloon after endoscopic submucosal dissection (ESD), with the aim of providing a reference for nursing care for this population. Method: Field interviews were conducted using purposive sampling. From January 2024 to June 2024, 50 patients who underwent follow-up treatment after endoscopic submucosal dissection at the Endoscopy Center of Dongfang Hospital in Shanghai were selected for interviews. Content analysis was used to summarize and extract themes. As a result, 5 themes and 11 sub-themes were extracted: Physiological discomfort (physical discomfort, an urgent desire to remove the balloon), psychological discomfort (sense of shame, anxiety), decreased quality of life (changes in daily habits, reduced sleep quality), expectation of social support (desire for understanding and respect, reliance on family support, longing for societal support), and inadequate disease self-management (poor prognosis awareness, compliance with balloon usage). Conclusion: Patients who use self controlled water balloon after endoscopic submucosal dissection still have a high demand for the use of water sacs, precautions, and various supports during the process, in addition to disease anxiety. In the future, multi-faceted intervention measures should be developed to promote better disease recovery and prompt resumption of normal life.