基于生命健康叙事理论的永久性结直肠癌造口患者心理健康素养影响因素的质性研究与护理对策 [中文引用][英文引用]

目的 探究永久性结直肠癌造口患者心理健康素养的影响因素，为制定永久性结直肠癌造口患者心理健康干预方案以提升其心理健康素养水平提供依据。方法 采用描述质性研究方法。采用目的抽样法，于 2024 年 10 月— 12 月选取贵阳市某三级甲等综合医院 15 例永久性结直肠癌造口患者作为研究对象，采用半结构式访谈法进行访谈，基于生命健康叙事理论和社会生态学模型，采用 Colaizzi 7 步分析法分析访谈资料。结果 提炼出 3 个主题 11 个亚主题：微观系统层面（个体心理健康信息获取能力、个体心理健康信息评价现状、个体心理健康信息应用能力、个人叙事素养、内化羞耻状况）、中观系统层面（医护与患者叙事连接、家庭成员间叙事连接、同伴间叙事连接、经济负担）、宏观系统层面（社会文化支持、信息支持）。结论 永久性结直肠癌造口患者心理健康素养影响因素包括微观、中观和宏观系统层面，应从个人、家庭、医院和社会等多个维度帮助患者构建良好的叙事关系，以提高其心理健康素养。

Objective To identify factors that influence mental health literacy in patients with permanent stoma after colorectal cancer surgery and to provide guidance for developing mental health interventions and improving mental health literacy for the patients. Methods Between October and December 2024，a semi-structured interviews was conducted on 15 patients with permanent stomas after colorectal cancer surgery in a Tier-IIIA hospital in Guizhou Province. With the life and health narrative theory and using the social ecological model，data acquired from the interviews with Colaizzi analysis were analysed. Results Three themes and eleven subthemes were extracted：micro-system（individual ability to obtain，evaluate and apply mental-health information，personal narrative literacy，and internalized shame）；meso-system（narrative connections with health professionals，family and peers，and financial strain）；and macro-system（sociocultural and informational support）. Conclusion Mental-health literacy is shaped by factors at micro-，meso- and macro-levels. It is essential to build supportive narrative relationships at individual，family，institutional and societal levels in order to improve mental-health literacy of the patients with permanent stoma after colorectal cancer surgery.