摘要
目的以健康生态学模型为框架,探讨糖尿病足患者延迟就医的原因。方法采用描述性现象学研究方法,2021年11月至2022年3月对20例延迟就医的糖尿病足患者进行面对面半结构式深度访谈,采用Colaizzi现象学7步法进行资料分析,提炼主题。结果根据健康生态学模型的5个层次,将延迟就医原因归纳为11个主题,个人特质层原因包括高龄患者感知觉衰退,足部溃疡未及时发现;行为特征层原因包括糖尿病足知识缺乏,消极治疗心理;人际网络层原因包括家庭支持力度不足,社会支持系统缺失;生活和工作条件层原因包括经济压力大,电子健康素养低,就诊不便;环境政策层原因包括医疗保险报销比例差异,医疗条件限制。结论糖尿病足患者延迟就医的原因是多层次系统性的,医务人员既需要从个体层面提高糖尿病患者足部的自我管理能力,同时也需要从系统层面探索相关的家庭、社会医疗支持资源,指导患者获得最佳医疗服务。
Objective To explore the reasons for delayed medical treatment in diabetic foot patients using the health ecology model as a framework.Methods From November of 2021 to March of 2022,descriptive phenomenological research methods was used in 20 patients with diabetic foot who delayed medical treatment were interviewed face-to-face semi-structured in depth,and the data analysis was carried out using the seven-step method of Colaizzi phenomenology to refine the theme.Results According to the five levels of the health ecology model,the reasons for delayed medical treatment were summarized into 11 themes,and the reasons for the personal trait layer included foot ulcers are not detected promptly,and the perceptual decline of advanced patients.Behavioral characteristics included lack of knowledge of diabetic foot,negative medical psychology.Reasons for the interpersonal network included insufficient family support and lack of social support;reasons for living and working conditions included high economic pressure,low electronic health literacy,and inconvenient medical treatment;the reasons for the policy environment included uneven medical insurance reimbursement ratios and limited medical conditions.Conclusions The reason for the delay in seeking medical treatment for diabetic foot patients is multi-layered and systematic,and medical staff need to improve the self-management ability of diabetic patients′feet from the individual level,and also need to guide patients from the system level on how to obtain the best medical resources.
作者
董亚楠
李香卿
姜晓锐
迟俊涛
Dong Yanan;Li Xiangqing;Jiang Xiaorui;Chi Juntao(Nursing School,Weifang Medical University,Weifang 261053,China;Hand and Foot Surgery,Yantai Yuhuangding Hospital,Yantai 264000,China;Department of Nursing,Yantai Yuhuangding Hospital,Yantai 264000,China)
出处
《中国实用护理杂志》
2023年第11期865-870,共6页
Chinese Journal of Practical Nursing
基金
山东省自然科学基金(ZR2019MH073)
烟台市科技计划项目(2019YD027)。
关键词
定性研究
糖尿病足
延迟就医
健康生态学模型
Qualitative research
Diabetic foot
Delayed medical treatment
Health Ecology Model
