作者：孙琼，宋涛，耿晶，姚园，冯高科

单位：

430060湖北省武汉市，武汉大学人民医院心内科

单位（英文）：

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China Corresponding author: GENG Jing, E-mail: gengli20010806@163.com

关键词：

急性心肌梗死；经皮冠状动脉介入治疗；步行试验；康复；质性研究

关键词（英文）：

Acute myocardial infarction; Percutaneous coronary intervention; Walk test; Rehabilitation; Qualitative research

中图分类号：

R 542.22

DOI：

10.12114/j.issn.1008-5971.2023.00.242

基金项目：

湖北省自然科学基金资助项目（2021CFB421）

摘要：

　目的　探讨急性心肌梗死（AMI）患者经皮冠状动脉介入治疗（PCI）术后早期行6分钟步行试验 （6MWT）的心理体验和康复需求。方法　采用目的抽样法，选择2022年6—12月武汉大学人民医院心内科收治的行 PCI的AMI患者12例，均进行6MWT。采用质性研究中的现象学研究方法，了解患者6MWT前后的体验，根据Colaizzi七 步法分析、整理资料，提炼共性问题，形成主题。结果　12例患者的6分钟步行距离（6MWD）为288～402 m，平均 （357.5±35.8）m。访谈时间为27～62 min，平均（43.6±9.8）min。共提炼出4大类主题：运动感知与认知偏差、社 会支持系统匮乏、个体化差异的康复需求、积极适应社会的康复需求。结论　AMI患者PCI后早期存在运动感知与认知 偏差，主要表现为运动恐惧、运动障碍、试验行为偏差和运动康复认知缺乏。患者的社会支持系统匮乏，体现在医疗 技术、经济、政策和家庭、工作方面。患者有个体化差异和积极适应社会的康复需求。

英文摘要：

　Objective To investigate the psychological experience and rehabilitation needs of undergoing early 6-minute walk test (6MWT) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) . Methods Purposive sampling method was used to select 12 patients with AMI who underwent PCI in the Department of Cardiology, Renmin Hospital of Wuhan University from June to December 2022. Conduct 6MWT, the phenomenological research method used in qualitative research was adopted to comprehend the experience of patients before and after 6MWT. Analyze and organize data using the Colaizzi seven step method, extract commonalities, and form a theme. Results The 6MWD of 12 patients was 288 to 402 m, with an average of (357.5±35.8) m. The duration of the interview ranged from 27 to 62 min, with an average of (43.6±9.8) min. Four major themes were extracted: motor perception and cognitive bias, lack of social support system, rehabilitation needs of individual differences, and need for positive social adaptation. Conclusion AMI patients have motor perception and cognition biases at the early stage after PCI, mainly including motor fear, motor disorder, experimental behavior bias and lack of motor rehabilitation cognition. The lack of social support system for patients mainly reflected in the aspects of medical technology, economy, policy, family and work. Patients have individual and different needs for rehabilitation and active reintegration into society.

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