摘要目的:探讨减重代谢术后患者居家自我管理的障碍因素，为构建减重代谢术后患者居家自我管理方案提供参考依据。方法:采用目的抽样法，于2021年2—3月选取上海市第十人民医院减重代谢中心的16例术后随访患者为研究对象，采用半结构化访谈对其进行访谈，并运用Colaizzi 7步分析法对文本资料进行分析和整理。结果:共提炼出8个主题：信息支持不足、家庭支持不足、术后依从性不佳、补偿性健康行为、负性情绪体验、预期病耻感、并发症困扰、体能下降。结论:减重代谢手术后患者居家自我管理存在诸多障碍因素，护理人员应根据障碍因素制订针对性的居家自我管理方案，以促进患者术后健康行为转变，提高其自我管理能动性。

abstractsObjective:To explore the obstacles to the home self-management of patients after bariatric and metabolic surgery, so to provide a reference for constructing a home self-management plan for patients after bariatric and metabolic surgery.Methods:From February to March 2021, purpose sampling was used to select 16 postoperative follow-up patients from the Bariatric and Metabolic Center of Shanghai Tenth People's Hospital as the research object. The semi-structured interview method was used to interview the patients, and the data were analyzed and sorted using the Colaizzi 7-step analysis method.Results:A total of 8 topics were extracted, including insufficient information support, insufficient family support, poor postoperative compliance, compensatory health behaviors, negative emotional experience, expected stigma, complications, and physical decline.Conclusions:There are many obstacles to the self-management of patients at home after bariatric and metabolic surgery. Nursing staff should formulate targeted home self-management programs for patients based on obstacles to promote the transformation of patients' health behaviors after surgery and increase their self-management initiative.