Xie Chunyan, Li Li, Li Yamin
Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, 410011, People's Republic of China.
Xiangya Nursing School of Central South University, Changsha, Hunan Province, 410013, People's Republic of China.
Risk Manag Healthc Policy. 2023 Feb 15;16:231-245. doi: 10.2147/RMHP.S401205. eCollection 2023.
Learned helplessness (LH) is a common psychological phenomenon among chronic disease patients. However, LH remains underrecognized in the context of maintenance haemodialysis (MHD) patients. This qualitative study is the first study of this topic to be conducted in a Chinese cultural context, and its purpose is to explore the LH experiences of MHD patients and to highlight their interpretations of LH.
We employed a qualitative research design. A purposive sampling method was used to recruit participants. The sample size was determined by data saturation. Data were obtained from MHD patients in a blood purification centre located in Hunan Province, China. Data were collected from June to September 2022. The researchers conducted in-depth, semistructured interviews with participants after obtaining informed consent. Texts were transcribed verbatim from the audio recordings of these interviews. Data processing and analysis were based on Giorgi's phenomenological approach.
Twenty-two respondents completed the interviews (aged 29-75 years, including ten females and twelve males). Four themes emerged from the interviews: (1) triggers of helplessness (hope is gone; witnessing renal friends' helplessness; out of control; nothing works); (2) being tied down (limitation; perceived loss; social isolation; giving in); (3) I am just a loser (self-image disorder; low self-concept; negative attitudes; guilt; abandonment); (4) alive day is the day (fatalism; my duty; downwards comparison).
The study reveals that multiple stressors drive MHD patients' LH. These salient phenomena demonstrate the importance of recognizing MHD patients' LH. We suggest that support services should be developed alongside a framework that addresses MHD patients' LH from the beginning of treatment.
习得性无助（LH）是慢性病患者中常见的心理现象。然而，在维持性血液透析（MHD）患者中，LH仍未得到充分认识。这项定性研究是在中华文化背景下首次针对该主题开展的研究，其目的是探索MHD患者的LH经历，并突出他们对LH的理解。
我们采用了定性研究设计。采用目的抽样法招募参与者。样本量由数据饱和确定。数据来自中国湖南省一家血液净化中心的MHD患者。数据收集于2022年6月至9月。在获得知情同意后，研究人员对参与者进行了深入的半结构化访谈。文本逐字转录自这些访谈的录音。数据处理和分析基于 Giorgi的现象学方法。
22名受访者完成了访谈（年龄在29 - 75岁之间，包括10名女性和12名男性）。访谈中出现了四个主题：（1）无助的触发因素（希望破灭；目睹肾友的无助；失去控制；无能为力）；（2）束缚（限制；感知到的损失；社会孤立；屈服）；（3）我就是个失败者（自我形象紊乱；低自我概念；消极态度；内疚；被抛弃）；（4）活着一天算一天（宿命论；我的责任；向下比较）。
该研究表明，多种压力源导致MHD患者出现LH。这些显著现象表明认识到MHD患者LH的重要性。我们建议应在从治疗开始就解决MHD患者LH问题的框架下，开发支持服务。
