老年脑卒中患者团体接纳承诺疗法干预后体验的质性研究 [中文引用][英文引用]

目的 了解老年脑卒中患者团体接纳承诺疗法（acceptance and commitment therapy，ACT）干预后体验，为完善老年脑卒中患者团体 ACT 干预策略提供参考。方法 运用描述性现象学的研究方法，采用目的抽样法，选择 2023 年 5 月— 7 月在本市某三级甲等综合医院接受团体 ACT 干预后 6 个月的 15 例老年脑卒中患者，进行半结构式深度访谈，采用 Colaizzi 7 步分析法分析资料。结果 老年脑卒中患者团体 ACT 干预后体验共析出 3 个主题、10 个副主题：①干预对心理和精神层面的影响（转变认知，悦纳自我；提升觉察，反观自我；澄清价值，适配自我；脱钩痛苦，实现解离；领悟痛苦，寻得生命意义感）；②干预带来的行为改变（转变生活方式，增进健康；康复锻炼，树立信心；增进社交，拥抱生活）；③对干预方案的建议（符合老年人生理特点；适应老年人心理特点）。结论 团体 ACT 干预对老年脑卒中患者心理、精神、行为的改变发挥有益作用，应结合其身心特点完善干预方案，提升老年脑卒中患者心理健康水平。

Objective To investigate the post-intervention experiences in elderly stroke patients who received the group-based acceptance and commitment therapy（ACT）and to provide a reference to improve the group-based ACT intervention strategies for the patients. Methods With the descriptive phenomenological research, the semi-structured in-depth interviews were conducted with 15 elderly stroke patients who had received the group-based ACT intervention for 6 months in a Tier-IIIA hospital in Hunan Province between May and July 2023. The data acquired from the interviews were analysed using the Colaizzi method. Results The experiences in elderly stroke patients with the group-based ACT intervention were categorised into three main themes and ten sub-themes：（1）The impact of intervention on the psychology and spirit（change cognition and accept oneself；enhance awareness and reflect on oneself； clarify values and adapt to oneself；disengage from suffering and achieve dissociation；understand suffering and discover a sense of meaning in life）；（2）Behavioural changes brought by the intervention（change approaches to improve health；engage in rehabilitation exercises and build confidence；enhance social interactions and integrate into life）；（3）Suggestions for the intervention program（tailor to the physiological characteristics of the elderly；adapt to the psychological characteristics of the elderly）. Conclusion The groupbased ACT intervention has a beneficial effect on the psychological, spiritual and behavioural changes in the elderly stroke patients. The intervention programs should be improved according to the physical and mental characteristics therefore to improve the mental health of elderly stroke patients.