老年慢性阻塞性肺疾病患者吞咽障碍的心理体验及护理需求的质性研究

doi:10.3969/j.issn.1006-9771.2025.01.011

Abstract

Abstract:

Objective To explore psychological experiences and care needs of elderly patients with chronic obstructive pulmonary disease (COPD) following dysphagia.

Methods From April to June, 2024, 13 elderly patients with COPD and dysphagia received treatment in Yixing No. 2 People's Hospital (Yixing Occupational Disease Institute) and Northern Jiangsu People's Hospital were interviewed. Nvivo 11.0 and content analysis were employed to analyze and summarize themes.

Results Two main themes were identified. The psychological experiences included fear of eating due to swallowing and choking, swallowing anxiety in social situations, concerns about malnutrition, and emotional loss related to family. The care needs included improvement in swallowing function, adjustment of food texture, assistance with disease adaptation and effective access to health education information.

Conclusion Healthcare professionals should thoroughly understand the psychological and needs of elderly patients with COPD-related dysphagia, and comprehensive nursing strategies should be developed and implemented to improve swallowing function and overall quality of life.

Key words: chronic obstructive pulmonary disease, dysphagia, empowerment theory, qualitative research

CLC Number:

R563.9

GONG Ping, DOU Yingru, DAI Xuemei, JIANG Xueping, WU Meifang, JIANG Fan. Psychological experiences and care needs of elderly patients with chronic obstructive pulmonary disease following dysphagia: a qualitative research[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(1): 117-124.

Figures/Tables 3

Table 1

Table 2

Table 3

References 43

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编号	性别	年龄/岁	文化程度	家庭收入/元	吸烟	饮酒	COPD 病程/年	并发疾病	COPD患者自我评估测试	Gugging 吞咽功能评估
N1	男	61	小学	3000~5000	是	已戒酒	10	糖尿病	中等	重度
N2	男	70	初中	3000~5000	是	是	15	高血压	中等	重度
N3	男	68	大学	3000~5000	是	是	22	糖尿病	中等	中度
N4	男	95	高中	3000~5000	否	否	45	糖尿病	中等	中度
N5	男	76	小学	< 3000	是	否	30	冠心病	严重	重度
N6	男	70	小学	3000~5000	否	否	35	糖尿病、高血压	中等	中度
N7	女	76	高中	3000~5000	已戒	是	18	无	严重	中度
N8	男	81	小学	3000~5000	是	否	30	高血压	中等	重度
N9	男	70	小学	6000~10000	否	否	28	冠心病	中等	中度
N10	女	76	高中	3000~5000	已戒	是	19	高血压	严重	中度
N11	女	76	初中	< 3000	是	否	20	无	中等	中度
N12	男	81	大学	> 10000	是	否	37	高血压、糖尿病	严重	中度
N13	男	74	高中	< 3000	是	否	44	高血压	中等	中度

项目	内容
内部赋能	您患有慢性阻塞性肺疾病多少年了?能否分享一些您对吞咽障碍的个人见解和感受?
	在慢性阻塞性肺疾病的影响下，进食时您遇到哪些困难?这些困难是如何影响您的日常生活和社交活动的?
	生病后您感觉饮食方面发生了哪些改变?您做了哪些努力或者采取了什么方法来调节适应目前的改变?您对于目前状况，您最担心什么?
	对于吞咽障碍的长期管理和治疗，您有何感想?您对生活质量有何预期?
外部赋能	您是否愿意学习或了解如何防治慢性阻塞性肺疾病吞咽障碍的相关知识?那您具体想要学习或了解哪方面的内容?
	您目前主要的需求是什么?您想通过哪些努力或者用什么方法来解决您的需求?
	在长年防治慢性阻塞性肺疾病吞咽障碍的过程中，您觉得什么因素对您的日常生活影响最大?
	您以前学过有关防治慢性阻塞性肺疾病吞咽障碍的方法吗?您现在希望通过什么方式来获得疾病教育方面的帮助?

初始代码		中级代码		高级代码		描述	主题
编号	开放式编码	编号	轴向式编码	编号	选择性编码	描述	主题
IC01	呛水、呛食、恐惧	MC01	呛咳事件的恐惧体验	HC01	吞咽呛咳产生进食恐惧感	患者在进食时因为呛咳而产生的恐惧心理	内心体验
IC02	社交焦虑、引起注意	MC02	社交场合中的吞咽焦虑	HC02	社交场合中的吞咽焦虑	在社交活动中，患者因吞咽问题而感到焦虑，担心引起他人注意
IC03	营养不足、食物限制	MC03	对营养状态的担忧	HC03	营养不足的担忧	患者担心因吞咽困难而无法摄入足够营养，影响健康
IC04	感到孤单、被忽视	MC04	家庭支持的缺失	HC04	家庭情感缺失	患者感到在抗病过程中缺乏家庭的理解和情感支持
IC05	需求吞咽训练、改善功能	MC05	需求吞咽功能改善	HC05	改善吞咽功能的需求	患者希望通过医疗干预改善吞咽功能，减少生活中的困扰	护理需求
IC06	食物硬度、黏度调整	MC06	调整食物质地需求	HC06	调整食物质地	患者需要根据吞咽能力调整食物质地，以确保安全饮食
IC07	心理支持、疾病适应	MC07	需求心理安慰和适应支持需求	HC07	疾病适应感援助	患者希望得到帮助，以更好地适应疾病带来的生活改变
IC08	疾病信息获取、信息渠道安全	MC08	需求疾病管理信息	HC08	安全获取疾病管理信息的需求	患者需要可靠的信息来源了解疾病管理和吞咽功能改善的方法

Psychological experiences and care needs of elderly patients with chronic obstructive pulmonary disease following dysphagia: a qualitative research

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