健康生态学视角下老年胃癌患者术前衰弱影响因素的质性研究

BackgroundPreoperative frailty is a severe negative state that reflects the reduction of overall physiological reserve and is highly prevalent in elderly patients with gastric cancer. Describing the perceived influencing factors of preoperative frailty can provide an important basis for developing individualized intervention plans. ObjectiveTo describe the perceived influencing factors of preoperative frailty among elderly gastric cancer patients. Methods A qualitative description was conducted based on health ecology theory. Purposive sampling method was used to select 29 frail elderly patients who would undergo gastric cancer surgery in a tertiary hospital in Jiangsu Province from February to June 2021 for semi-structured interview. Directed content analysis was used for data analysis. ResultsFive themes and thirteen sub-themes were extracted: physiological traits, including accumulated aging-related losses, obvious gastrointestinal symptoms, and successive attacks of diseases; behavioral characteristics, including lack of exercise behavior and excessive physical activity exertion; interpersonal networks, including insufficient peer social interaction, lack of parent-child interaction, and lack of communication and self disclosure between couples; living and working conditions, including heavy individual financial burden, heavy unplanned family care tasks, insufficient resources for health and disease management information; macro factors, including limited level of medical services and medical insurance support. ConclusionThis study described the perceived effects of different dimensional factors on preoperative frailty among elderly gastric cancer patients from the perspective of health ecology. Medical staff should formulate and implement systematic prehabilitation programs based on the above factors to improve the patients' preoperative anti-stress ability and postoperative outcomes.