基于ERG需求理论的复发脑卒中患者预立医疗照护计划服务需求与偏好的质性研究

A Qualitative Study on the Service Needs and Preferences for Advance Care Planning among Patients with Recurrent Stroke Based on the ERG Demand Theory

摘要: 目的：基于生存–关系–成长需求理论探索复发脑卒中患者预立医疗照护计划服务的需求与偏好，为构建需求分层化与精准化的服务体系提供参考。方法：2024年8月~10月采用目的抽样，对15名在湖北省某三甲医院住院的复发脑卒中患者进行深入访谈，运用六阶段主题分析法进行资料分析。结果：复发脑卒中患者预立医疗照护计划服务的需求及偏好归纳为3个层次：生存层次主要是心理社会支持和信息认知需求；相互关系层次包括家庭共同决策、社区服务可及性、团队综合服务和政策保障需求；成长层次为预先决策偏好及尊严善终偏好。结论：复发脑卒中患者对预立医疗照护计划服务的需求呈层次性与递进性，建议构建“家庭–社区–政策”支持系统，实现持续化与长期化的预立医疗照护计划服务。

Abstract: Objective: To explore the needs and preferences for Advance Care Planning services among recurrent stroke patients based on Existence-Relatedness-Growth theory, providing a foundation for a stratified and precise service system. Methods: From August to October 2024, purposive sampling was used to conduct in-depth interviews with 15 recurrent stroke patients in a tertiary hospital in Hubei Province, and data were analyzed using a six-phase thematic approach. Results: Three levels of needs were identified: existence needs for psychosocial support and information; relatedness needs involving family decision-making, community service accessibility, integrated team services, and policy support; and growth needs for early decision-making and dignified end-of-life care. Conclusion: Needs for Advance Care Planning services among recurrent stroke patients are layered and progressive, and developing a family-community-policy support system is recommended to ensure continuous and long-term service delivery.