目的 基于旅程地图探索超低位直肠癌预防性造口患者全周期治疗过程中的体验，为今后优化患者全周期的护理质量提供参考。方法 采用描述质性研究方法，以目的抽样法选取北京市某三级甲等医院肛肠外科15例超低位直肠癌预防性造口患者进行参与式观察及半结构化访谈，通过传统内容分析法分析资料并绘制旅程地图。结果 按诊疗阶段划分为诊断决策期、造口适应期、功能重建期及稳定康复期4个阶段，从行为、情绪、痛点3个方面归纳经验化自我应对、就医抉择等35条主题。结论 超低位直肠癌预防性造口患者治疗复杂、周期长，医护人员应系统识别患者各治疗阶段的需求，实施个性化照护方案，改善患者就医体验。

Objective To explore the experience of patients with prophylactic ileostomy (PI) for ultra-low rectal cancer (ULRC) throughout the full-cycle treatment process based on the journey map,so as to provide reference for optimizing the quality of nursing care throughout the entire treatment cycle.Methods A descriptive qualitative research method was adopted.15 patients with PI for ULRC from the department of colorectal surgery of a tertiary A hospital in Beijing were selected by purposive sampling for participatory observation and semi-structured interviews.Data were analyzed by the traditional content analysis and a journey map was drawn.Results According to the diagnosis and treatment stages,the process was divided into 4 stages:diagnosis and decision-making period,ostomy adaptation period,functional reconstruction period,and stable rehabilitation period.A total of 35 themes,including experiential self-coping,medical decision-making,were summarized from 3 aspects:behavior,emotion,and pain points.Conclusions The treatment of patients with PI for ULRC is complex and of long duration.Medical staff should systematically identify patients' needs at each treatment stage,implement individualized care plans,and improve patient experience.

R473.6

国家自然科学基金(82172845)