目的 探讨中青年乳腺癌患者及其配偶在社会再融合过程中二元应对的障碍因素，为制订针对性干预策略提供参考依据。方法 基于系统交互模型，开展描述性质性研究。采用目的抽样法，选取桂林市某三级甲等医院乳腺外科复诊的16对中青年乳腺癌患者及其配偶进行半结构式访谈，运用Colaizzi 7步分析法和二元数据分析法对资料进行分析、提炼主题。结果 共归纳出个体身心困境、二元互动失调、系统支持缺位和社会文化排斥等4个主题及10个亚主题。结论 中青年乳腺癌患者及其配偶在社会再融合阶段的二元应对障碍受多层面因素的影响，医护人员可从个体、关系与社会3个维度构建干预方案，助力患者夫妇顺利实现社会再融合。

Objective To explore the dyadic coping barriers to social reintegration among young and middle-aged breast cancer patients and their spouses,so as to provide reference for formulating targeted intervention strategies.Methods A descriptive qualitative study was conducted based on the systemic interaction model.Using purposive sampling method,16 pairs of young and middle-aged breast cancer patients and their spouses who received follow-up visits in the Department of Breast Surgery of a tertiary A hospital in Guilin city were selected for semi-structured interviews.Colaizzi’s 7-step analysis method and dyadic data analysis were adopted to analyze and extract themes from the data.Results Four themes and ten sub-themes were summarized,including physical and psychological dilemmas at the individual level,dyadic interaction disorders,inadequate systemic support,and social and cultural exclusion.Conclusions Dyadic coping barriers to social reintegration among young and middle-aged breast cancer patients and their spouses are affected by multi-level factors.Medical staff can develop intervention programs from the individual,relational and social dimensions to help the patient couples achieve smooth social reintegration.

R473.73

桂林市科学研究与技术开发计划项目(20210227-8-1）；桂林医科大学护理科研基础能力提升项目（202504023）