目的 探索冻结肩手法松解术后患者功能锻炼的促进和阻碍因素，为制订针对性的干预措施提供依据。方法 2024年4-6月,采用目的抽样法选取苏州某三级甲等医院疼痛科收治的15例冻结肩手法松解术后患者为研究对象，基于理论域框架制订访谈提纲并进行半结构式访谈，采用定向内容分析法进行分析。结果 共提炼出冻结肩手法松解术后患者功能锻炼的促进因素包括疼痛驱动、获益感驱动、健康信念、对专业人士的信任和认可、简便的锻炼方式和习惯等6个主题及10个亚主题，阻碍因素包括缺乏知识、缺乏技能、身体困扰、负性情绪困扰、低自我效能、缺乏支持、社会/职业角色冲突、信息资源获取受限和行为计划等9个主题及17个亚主题。结论 冻结肩手法松解术后患者的功能锻炼受多种促进与阻碍因素影响，可通过优化教育方式、缓解负性情绪、强化疼痛管理和增强社会支持等多种途径，提高其功能锻炼依从性。

Objective To explore the facilitators and barriers to functional exercise in patients after manipulation under anesthesia(MUA) for frozen shoulder,and to provide a basis for developing targeted intervention measures.Methods From April to June 2024,a purposive sampling method was used to select 15 patients admitted to the Pain Management Department of a tertiary A hospital in Suzhou who underwent MUA for frozen shoulder.Based on the Theoretical Domains Framework,an interview outline was developed,and semi-structured interviews were conducted.Data were analyzed using directed content analysis.Results A total of 6 themes and 10 sub-themes were identified as facilitators for functional exercise after MUA for frozen shoulder：pain-driven motivation,perceived benefits-driven motivation,health beliefs,trust and recognition of professionals,simple exercise methods,and habits.For barriers,9 themes and 17 sub-themes were identified：lack of knowledge,lack of skills,physical discomfort,negative emotional distress,low self-efficacy,lack of support,social/occupational role conflict,limited access to information resources,and behavioral planning.Conclusions Functional exercise in patients after MUA for frozen shoulder is influenced by various facilitators and barriers.Adherence to functional exercise can be improved by optimizing educational methods,alleviating negative emotions,strengthening pain management,and enhancing social support.

R47

国家自然科学基金（82301387）