Improving the level of benefit finding can help alleviate the high prevalence of negative emotional problems and promote mental health in maintenance hemodialysis (MHD) patients, so the research group has constructed a benefit finding promotion program for MHD patients based on the PERMA flourish model in the earlier stage, which is urgently needed to be applied in clinical practice.

To explore the barriers and facilitators to the implementation of benefit finding promotion program for MHD patients, and provide reference for psychological intervention of them.

Using purposive sampling method, 12 healthcare workers and 9 MHD patients in the hemodialysis unit of the Second Affiliated Hospital of the Naval Medical University were selected as the study subjects from March to May 2023, and semi-structured interviews were conducted with them using the phenomenological research method, and the results of the interviews were analyzed in terms of the three dimensions of change, change recipients, and the organizational environment based on the i-PARIHS framework, and the responses to the obstacle factors were developed.

Barriers to the application of the program at the change level include lack of detail, high professionalism, and cultural differences in the program content; at the recipient level include cognitive differences in the team, lack of psychosocial training for healthcare workers, low motivation of patients to participate, and inconsistent acceptance; at the organizational environment level, the lack of incentives in the ward, and the lack of a suitable place for the intervention. Factors facilitating the implementation of the program include, on the change side, interventions derived from high-quality research, richness and variety of program content, etc., on the receiver side, strong support from the ward leadership, positive cooperation from team members, etc., and on the organizational environment side, the ward has a certain base of psychological interventions, and changes are in line with national and health policies.

The application of benifit finding promotion program for MHD patients is affected by a variety of factors, the need to comprehensively analyze the barriers and facilitators, and to take specific action strategies to promote the program to the ground, so that it is orderly and efficient in the clinical implementation of the application.

提高益处发现水平有助于缓解维持性血液透析（MHD）患者高发的负性情绪问题，促进心理健康，因此课题组前期基于PERMA心盛模型构建了MHD患者益处发现促进方案，亟待临床应用。

探讨MHD患者益处发现促进方案实施的障碍及促进因素，为MHD患者心理干预提供参考。

采用目的抽样法，于2023年3—5月选择海军军医大学第二附属医院血透室的12名医护人员和9例MHD患者为研究对象，采用现象学研究方法对其进行半结构式访谈。基于i-PARIHS框架，从变革、变革接受者和组织环境三个层面对访谈结果进行分析，并制订障碍因素对策。

影响本方案应用的障碍因素在变革层面包括方案内容具体性欠佳、专业性较强、具有文化差异等，接受者层面包括团队认知差异、医护人员缺乏心理干预培训、患者参与积极性不高、接受程度不一致等，组织环境层面包括病区缺乏相关激励机制、合适的干预场所等；促进方案实施的因素在变革方面包括干预措施来源于高质量研究、方案内容丰富、形式多样等，接受者方面包括病区领导的大力支持、团队成员的积极配合等，组织环境方面包括病区具有一定的心理干预基础、变革符合国家政策导向等。

MHD患者益处发现促进方案应用受到多方面因素的影响，需要全面分析障碍因素和促进因素，并采取具体的行动策略促进方案落地，使其有序高效地在临床中实施应用。