Page 75 - 2023-08-中国全科医学

·972· http: //www.chinagp.net E-mail: zgqkyx@chinagp.net.cn March 2023, Vol.26 No.8

·专题研究·癌症衰弱·

健康生态学视角下老年胃癌患者术前

衰弱感知影响因素的质性研究

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丁玲玉 1，2 ，蒋小曼 ，缪雪怡 ，陈丽 ，朱涵菲 ，陆金玲 ，胡洁蔓 ，徐欣怡 ，许勤 1* 查看原文
【摘要】 背景 术前衰弱是一种反映整体生理储备降低的严重负性状态，在老年胃癌患者中高发，描述患者感
知的衰弱影响因素可为制订针对性干预方案提供重要依据。目的 基于健康生态学理论通过质性研究具体描述老年胃
癌患者感知的术前衰弱影响因素。方法 基于健康生态学理论，通过描述性质性研究，利用目的抽样法选取 2021 年 2—
6 月南京医科大学第一附属医院收治的拟行胃癌手术的 29 例老年衰弱患者进行半结构式访谈。运用定向内容分析法进
行资料分析。结果 共提炼出 5 个主题及 13 个亚主题：（1）生理特质，包括老化相关损耗累积、消化道症状明显、
多病打击持续；（2）行为特点，包括运动行为缺乏、体力活动消耗显著；（3）人际网络，包括同伴社交不足、亲子
互动缺乏、夫妻间沟通及自我表露缺乏；（4）生活和工作条件，包括个人经济负担沉重、计划外家庭照顾任务繁重、
健康与疾病管理信息资源不足；（5）宏观因素，包括医疗服务水平受限及医保支持力度受限。结论 本研究具体描
述了健康生态学视角下老年胃癌患者所感知的不同维度因素对术前衰弱的影响，医护人员可基于上述多维因素制订及
实施系统性的预康复方案，以有效提高老年胃癌患者的术前抗应激能力，改善术后结局。
【关键词】 胃肿瘤；胃癌；衰弱；老年人；健康生态学；质性研究；半结构式访谈
【中图分类号】 R 735.2 R 364 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2022.0732
丁玲玉，蒋小曼，缪雪怡，等 . 健康生态学视角下老年胃癌患者术前衰弱感知影响因素的质性研究［J］. 中国全
科医学，2023，26（8）：972-979. ［www.chinagp.net］
DING L Y，JIANG X M，MIAO X Y，et al. Perceived influencing factors of preoperative frailty among elderly patients with
gastric cancer from the perspective of health ecology：a qualitative study［J］. Chinese General Practice，2023，26（8）：972-979.

Perceived Influencing Factors of Preoperative Frailty among Elderly Patients with Gastric Cancer from the Perspective
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of Health Ecology：a Qualitative Study DING Lingyu 1，2 ，JIANG Xiaoman ，MIAO Xueyi ，CHEN Li ，ZHU Hanfei ，LU
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Jinling ，HU Jieman ，XU Xinyi ，XU Qin 1*
1.School of Nursing，Nanjing Medical University，Nanjing 211166，China
2.Department of Colorectal Surgery，the First Affiliated Hospital with Nanjing Medical University，Nanjing 210029，China
3.Department of Gastric Surgery，the First Affiliated Hospital with Nanjing Medical University，Nanjing 210029，China
4.Faculty of Health，Queensland University of Technology，Brisbane QLD 4000，Australia
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Corresponding author：XU Qin，Professor，Doctoral supervisor；E-mail：qinxu@njmu.edu.cn
【Abstract】 Background Preoperative frailty is a severely unhealthy status that reflects the reduction of overall
physiological reserve，which is highly prevalent in elderly patients with gastric cancer. Understanding the perceived influencing
factors of preoperative frailty can provide an important basis for developing individualized intervention plans. Objective To
perform a qualitative descriptive study to identity the perceived influencing factors of preoperative frailty among elderly gastric
cancer patients using the theory of health ecology. Methods A qualitative descriptive study was conducted based on health
ecology theory. Purposive sampling method was used to select 29 frail elderly patients who would undergo gastric cancer surgery in
the First Affiliated Hospital with Nanjing Medical University from February to June 2021 for semi-structured interview. Directed
content analysis was used for data analysis. Results Five themes and thirteen sub-themes were extracted：physiological traits，
including accumulated aging-related losses，obvious gastrointestinal symptoms，and successive attacks of multiple diseases；
behavioral characteristics，including lack of exercise behavior and overexertion；interpersonal networks，including insufficient

基金项目：国家自然科学基金面上项目（82073407）——健康生态学视阈下胃癌幸存者衰弱轨迹探究及干预方案设计
1.211166 江苏省南京市，南京医科大学护理学院 2.210029 江苏省南京市，南京医科大学第一附属医院结直肠外科 3.210029
江苏省南京市，南京医科大学第一附属医院胃外科 4.QLD 4000 澳大利亚昆士兰州布里斯班，昆士兰科技大学健康卫生学院
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通信作者：许勤，教授，博士生导师；E-mail：qinxu@njmu.edu.cn
本文数字出版日期：2022-11-30