中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (01): 82-86.doi: 10.3969/j.issn.1671-4091.2026.01.019

• 护理研究 • 上一篇    下一篇

基于自我管理视角的腹膜透析患者医疗机构就诊需求的质性研究

刘婷婷   富晶晶    张晓红    章海芬    王雅雯    黄佳颖    顾乐怡    方 炜    奚慧琴   

  1. 200127 上海，上海交通大学医学院附属仁济医院1护理部 3肾脏科
    200025 上海，2上海交通大学护理学院
    200127 上海，4上海市腹膜透析研究中心
  • 收稿日期:2025-05-14 修回日期:2025-09-10 出版日期:2026-01-12 发布日期:2025-12-31
  • 通讯作者: 奚慧琴 E-mail:xihuiqin@renji.com
  • 基金资助:
    上海市医院协会医院管理研究基金(X2022133)；上海申康医院发展中心第二轮《促进市级医院临床技能与临床创新三年行动计划》2023年度研究型医师创新转化能力培训项目（SHDC2023CRS013）；上海交通大学医学院护理学科建设项目（SJTUHLXK2024）；上海市卫生健康委员会卫生健康政策研究课题项目(2024HP45)

The needs of peritoneal dialysis patients for medical institutions from the perspective of self-management: a qualitative study

LIU Ting-ting, FU Jing-jing, ZHANG Xiao-hong, ZHANG Hai-fen, WANG Ya-wen, HUANG Jia-ying, GU Le-yi, FANG Wei, XI Hui-qin   

  1. Department of Nursing and 3Department of Nephrology, Renji Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200127, China; 2School of Nursing, Shanghai JiaoTong University, Shanghai 200025, China; 4Shanghai Peritoneal Dialysis Research Center, Shanghai 200127, China
  • Received:2025-05-14 Revised:2025-09-10 Online:2026-01-12 Published:2025-12-31
  • Contact: 200127 上海，上海交通大学医学院附属仁济医院1护理部 E-mail:xihuiqin@renji.com

摘要： 目的  分析腹膜透析患者医疗机构就诊需求，旨在为优化资源分布、提升腹膜透析居家管理效果提供思路。 方法  采用目的抽样法选取2024年6月在上海交通大学医学院附属仁济医院随访的腹膜透析患者，以信息饱和为原则停止招募。对腹膜透析患者进行半结构式访谈，采用Colaizzi 7步分析法进行资料分析。 结果  最终纳入15位腹膜透析患者，根据访谈结果共提炼出3个主题8个亚主题：自我管理困境(信息感知困境；工作生活受限；随访可及性差；疾病及情绪相关困扰)、需求阶段性变化特征(住院管理需求；居家自我管理需求)、医疗机构就诊需求层次化(医院就诊需求；社区服务需求)。 结论  腹膜透析居家自我管理过程中遭遇多重阻碍，服务需求呈现阶段性差异化，未来应在政策指引下助力优质资源下沉，进一步完善支持系统。

关键词: 腹膜透析, 自我管理, 医疗机构就诊需求, 质性研究

Abstract: Objective  To analyze the needs of peritoneal dialysis (PD) patients for medical institutions, in order to provide ideas for optimizing resource allocation and improving PD home management.  Methods  Purposive sampling method was used to select PD patients who were followed up at Renji Hospital, Shanghai JiaoTong University School of Medicine in June 2024, and the recruitment was stopped based on the principle of information saturation. Semi-structured interviews were conducted with the PD patients. The Colaizzi's 7-step analysis method was adopted for data analysis.  Results  A total of fifteen PD patients were ultimately included. Based on the interview results, 3 themes and 8 sub-themes were extracted: self-management difficulties (information perception difficulties; limited work and life; poor accessibility to follow-up; disease and emotional distress), phased change characteristics of needs (hospitalization management needs; home self-management needs), hierarchical needs for medical treatment in medical institutions (hospital treatment needs; community service needs).  Conclusions  During the self-management of home PD, patients encounter multiple obstacles and the service needs present differentiated stages. Medical staff should strengthen the accessibility of medical resources and improve the support systems.

Key words: Peritoneal dialysis, Self-management, Needs of medical institutions, Qualitative study

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