老年食管癌并发气管食管瘘患者症状体验与应对的质性研究

doi:10.3969/j.issn.1003-9198.2026.04.012

摘要/Abstract

摘要： 目的了解老年食管癌并发气管食管瘘患者的症状体验与应对,为患者临床干预策略的制订提供参考依据。方法采用现象学研究法,选取2024年1—12月在南京医科大学第一附属医院消化内科住院的17例老年食管癌并发气管食管瘘患者进行半结构式深入访谈,并采用Colaizzi 7步分析法对访谈资料进行分析、归纳及提炼主题。结果老年食管癌并发气管食管瘘患者的症状体验与应对可归纳为4个主题:症状体验(呼吸道症状、睡眠剥夺、疲乏、肠内营养相关性不舒适),情感认知体验(心理痛苦、疾病认知重构、感知社会支持),应对策略(积极应对、社会疏离),未满足的支持需求(疾病信息获取需求、延续性护理需求)。结论老年食管癌并发气管食管瘘患者在生理、心理、社会等方面存在诸多负担和需求,提示医护人员亟需优化症状管理策略,重视患者负性情绪,发展积极心理资源,强化信息支持与延续性护理,从而改善患者症状、增强疾病应对能力,促进其身心健康。

关键词: 气管食管瘘, 食管癌, 症状体验, 应对, 质性研究

Abstract: Objective To explore the symptom experiences and coping strategies of elderly patients with esophageal cancer complicated with tracheoesophageal fistula (TEF), and to provide references for the development of clinical interventions. Methods Using the phenomenological research method, 17 patients with esophageal cancer complicated with TEF, were recruited from January to December 2024. Semi-structured in-depth interviews were conducted, and the Colaizzi 7-step analysis method was used to analyze, summarize and refine the themes of interview data. Results Four themes were extracted, including symptom experience (respiratory symptoms, sleep deprivation, fatigue, enteral nutrition-related discomfort), emotional and cognitive experience (psychological distress, illness cognition restructuring, perceived social support), coping strategies (active coping, social isolation), unmet support needs (disease-related information, transitional care). Conclusions Elderly patients with TEF experience multiple burdens and needs, suggesting that medical staff should optimize symptom management strategies, address negative emotions proactively, cultivate positive psychological resources, and strengthen information support and transitional care to alleviate symptoms, enhance disease coping capacities and promote physical and mental well-being.

Key words: tracheoesophageal fistula, esophageal cancer, symptom experiences, coping, qualitative study

中图分类号:

R 735.1

陆希, 丁文琴, 张国新, 程文芳, 张道权, 刘梅红, 伍萍. 老年食管癌并发气管食管瘘患者症状体验与应对的质性研究[J]. 实用老年医学, 2026, 40(4): 389-393.

LU Xi, DING Wenqin, ZHANG Guoxin, CHENG Wenfang, ZHANG Daoquan, LIU Meihong, WU Ping. A qualitative study on symptom experiences and coping strategies in elderly patients with esophageal cancer complicated with tracheoesophageal fistula[J]. Practical Geriatrics, 2026, 40(4): 389-393.

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