目的 探讨造口患者居家沐浴行为障碍的原因，为制订相关护理方案提供参考依据。方法 2023年8-12月，采用目的抽样法选取杭州市某三级甲等医院专科门诊随访的20名造口患者为研究对象。基于计划行为理论设计访谈提纲，运用描述性质性研究方法进行主题分析和提炼。结果 造口患者居家沐浴行为障碍可归纳为3个主题：态度障碍，风险感知与价值认同的冲突；主观规范缺位，社会支持与医护专业引导的不足；行为控制感知受限，资源与能力的双重制约。结论 造口患者居家沐浴行为受多维度因素制约，需统筹认知重构（破解风险误判）、规范协同（构建多重支持网络）、资源整合（优化技能与资源可及性）三维干预策略，改善造口患者的沐浴行为和生活质量。

Objective To explore the reasons for barriers to home bathing behavior in ostomy patients and provide reference for developing relevant nursing intervention.Methods From August to December 2023,20 ostomy patients followed up at a specialist clinic of a tertiary A hospital in Hangzhou were selected using purposive sampling.An interview outline was designed based on the theory of planned behavior,and thematic analysis was conducted using a descriptive qualitative research approach.Results The barriers to home bathing behavior in ostomy patients were categorized into 3 themes:attitudinal barriers-conflict between risk perception and value recognition;absence of subjective norms-insufficient social support and professional guidance;limitations on perceived behavioral control-dual constraints of resources and capabilities.Conclusions Home bathing behavior in ostomy patients is influenced by multidimensional factors.Comprehensive intervention strategies are needed,including cognitive restructuring (addressing misperceptions of risk),norm coordination (building a multi-level support network),and resource integration (optimizing skills and accessibility),to improve bathing behavior and the quality of life.

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浙江省中医药科技计划项目（2024ZL542）；浙江大学医学院附属第一医院护理学科建设科研项目（2023ZYHL41）