Qualitative study of experience of patients with external drainage tube out of hospital with biliary and pancreatic system diseases

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Methods: An objective sampling method was used to select patients treated in the Department of Hepatobiliary Surgery and the Pipeline Nursing Outpatient Department of a triple A hospital in Yinchuan City, Ning Xia province, China, and had external drainage tubes in place outside the hospital for more than one month as research objects. Semi-structured interviews were conducted under the guidance of phenomenological research methods, and 17 participants were finally included. This study was reviewed by the Research Ethics Committee of the General Hospital of Ningxia Medical University (Ethics number: KYLL-2022-1341), and all subjects voluntarily participated in this study. Results: Four themes and ten sub-themes were extracted, including negative experiences in social life (reinforcement of patient role and absence of family role, changes in work, life, and lifestyle), physical and mental discomfort experience (negative psychological experience and physical discomfort experience), lack of related knowledge (lack of disease-related knowledge, lack of pipeline nursing skills, and weak consciousness). and hope to get help (obtain the appropriate size of the drainage bag, improve fixed film, and the follow-up method). Conclusion: The patients’ experience of patients with drainage tube outside of hospital for hepatobiliary and pancreatic system diseases is primarily discomfort. There are some discomfort experiences and a lack of relevant-disease knowledge, and patients are eager to get professional help from the medical staff. Biliary pancreatic system diseases Home with tube Patient experience with tubes Qualitative research Figures Figure 1 Introduction With the continuous development of various treatment technologies and progress in minimally invasive diagnostic and therapeutic strategies, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography and drainage (PTCD), endoscopic nasobiliary drainage (ENBD) (Liu,2017; Liao et al, 2022), and other minimally invasive endoscopic approaches have become the preferred treatment for biliary and pancreatic diseases (Liu et al,2023). After treatment, it is necessary to place external drainage tubes, including nasobiliary/pancreatic drainage tubes, biliary/gallbladder puncture drainage tubes, and peripancreatic puncture drainage tubes to alleviate obstruction of the biliary and pancreatic systems, reduce local exudation of organs (Xu et al,2020), and achieve adequate drainage and disease treatment. External drainage tubes are often necessary to be placed for two weeks to three months(Peng et al,2022). Patients frequently face out-of-hospital medical decisions with drainage tubes. Although most patients were in stable condition after discharge, their physical function did not fully recover, and they were in a transitional state of recovery. The incidence of complications related to the out-of-hospital catheter was as high as 17.2%–39.5%, mainly including skin rupture around the puncture point, pipeline blockage, unplanned extubation, extubation or displacement, infection, and other complications(Rizzo et al,2020). Physical and psychological effects on patients and their families have varying degrees (Qi et al,2019), seriously affecting the quality of life. Patient experience refers to the psychological feelings of patients during the medical treatment and nursing process and the experience of the details of the entire process(Chen et al,2019). Relevant studies on patient experience have mainly focused on the postoperative experience of patients with breast cancer (Mei et al, 2019) and chronic disease self-management experience[(Balduino et al, 2016). Currently, only a few studies have focused on the patients’ experience of patients with peripherally inserted central catheter(PICC)(Wang et al, 2019) and enterostomy out-of-hospital (Liu et al, 2022). The findings revealed that patients often have a decline in quality of life, restrictions on social activities, changes in body image (Guo et al, 2024), and even adverse events such as infection and tube blockage (Ojo et al, 2019). However, there are few reports on the tube experience of patients with external drainage tubes outside the hospital. Consequently, this study aimed to understand the experiences of patients with external drainage tube outside hospital with biliary and pancreatic system diseases through qualitative research to provide a theoretical basis and reference for formulating nursing intervention measures based on the actual experiences of patients with ducts. OBJECTS AND METHODS 1.1 Research object The objective sampling method was used to select patients as study participants who were admitted to the Department of Hepatobiliary Surgery and Pipeline Nursing Outpatient Department of a triple A hospital in Yinchuan City, Ning Xia province, China, from December 2023 to March 2024 and had external drainage tubes in place outside the hospital for more than one month. The inclusion criteria were as follows: ①patients aged 18–65 years; ②patients with out-of-hospital catheters for > 1 month; ③patients who knew the condition were willing to participate in the interview under informed conditions and had good communication skills. The exclusion criteria were as follows: ①Patients with malignant tumors. Patients with drainage tubes were placed based on the concept of palliative care; ②the disease suddenly worsened during the indwelling tube. This study was reviewed by the Research Ethics Committee of the General Hospital of Ningxia Medical University (Ethics number: KYLL-2022-1341). All participants voluntarily participated in this study. 1.2 Survey Tools 1.2.1 Formulation of the first draft of the interview outline With "nasobiliary drainage tube", "PTCD", "percutaneous hepatobiliary puncture", "T tube", "patient experience", "out-of-hospital catheter", "home catheter" and "catheter experience" as search terms were used to search and retrieve relevant literature in PubMed, China National Knowledge Infrastructure(CNKI), Wanfang Medical Network, and other databases, to summarize the literature, and to form the first draft of the interview outline. 1.2.2 Formation of the final interview outline Two subjects meeting inclusion and exclusion standards were selected for the pre-interview, and the final interview outline was prepared after discussion and revision by the research team. The final draft was as follows: ①What is your first feeling when you learned that you need to carry drainage tube for some time after discharged? ②What is the biggest trouble for you with the drainage tube outsied hospital? ③What are your biggest concerns during tube drainaging out of hospital? ④What impact does place drainage tube during the out-of-hospital have on your life and work? ⑤What kind of help do you want to get during drainage after discharge from medical staff? 1.3 Conducting interviews 1.3.1 Preparation before interview ①Patient preparation: Interviews were conducted with patients in the Pipeline Nursing Outpatient Department of the a triple A hospital in Yinchuan after the appointment with consent. ②Goods preparation: One voice recorder, one notebook (to record body language, such as expression, tone, and mood change), one pen, one general interview data sheet, and some interview record charts. ③Environmental preparation: This should be carried out in a place with sufficient light and a quiet environment, and the time is generally selected after the patient's treatment finished. The interview site of this study was a corridor next to the Pipeline Nursing Outpatient Department of a triple A hospital in Yinchuan City, Ning Xia province, China. 1.3.2 Conducting formal interviews The data were collected through semi-structured interviews and observations. Before the interviews, the researcher explained the purpose, content, and process of the research in detail to the interviewees and ensured that the interview content was only for academic research. The entire process was recorded with the consent of the interviewees. 1～2 patients were interviewed each time, each for 20～40 min. Focus on the interview content according to the outline, but do not stick to it. Using interview skills such as listening, summarizing, induction, verification, and repetition encourage patients to express their true feelings and opinions. Concurrently, it is necessary to take interview notes and record the non-body language, such as complexion, micro-expression, intonation changes, and mood fluctuations and so on. Appropriate follow-up questions were asked based on the patient's answers to obtain more detailed and comprehensive information during the interviews. Should be avoid seductive questions and listen patiently during the interviews. If patients occur sudden emotional agitation or discomfort during the interview, it should be immediately suspended or ended. According to the principle of saturation in qualitative research data collection, three to four patients were continued to be interviewed after no new topics appeared until their main problems were identified. Finally, 17 patients were interviewed in this study. 1.4 Data collection and analysis Data collection and analysis were performed simultaneously. The interview data were processed anonymously, and the names of the interviewees were replaced with numbers from P1 to P17. The interview contents were sorted out and analyzed within 24 hours after the interview First, the data from the recorded interviews were transcribed word by word and analyzed using the seven-step method of Colaizzi phenomenology(Liu,2008). The data analysis process was completed independently and simultaneously by two researchers and the controversial contents were discussed with the members of the research group and reached a consensus. 1.5 Theme integration Data content was coded and classified, and similar content was summarized and organized to form themes and sub-themes. Finally, the extracted topics and subtopics were sorted according to their frequency of occurrence. 1.6 Quality control Before the interview, the researcher communicated with the patient to ensure the interview participants were familiar with and trusted the researcher. It was necessary to reveal their true feelings during interviews. The researcher has received training related to qualitative research, and the researcher and the Pipeline Outpatient Specialist Nurses provide relevant nursing services and health guidance to build a friendly and trusting relationship with the patients and to ensure the credibility of the obtained data from object of study. The researcher did not make any judgments about the interview content of the participants during the interview. The recording content was converted into a manuscript within 24h of the interview. If the transcript was inaccurate for patients who used dialects, the researcher retrospectively transcribed the recording file manually. When there are questions or uncertain information, confirm the information with the interviewee as necessary. Results 2.1 General information of research objects This study included 17 patients (11 male and 6 female patients). The mean patient age was (50 ± 9.4) years, and the mean duration of catheter placement time was (37 ± 8.9) days. And there were nasobiliary drainage tubes, gallbladder puncture drainage tubes, nasopancreatic drainage tubes, pancreatic puncture drainage tubes, and T tubes (Table 1). Table 1 General data table of patients with drainage tube out-of-hospital (n=17) NO Age (year) Gender Education background Occupation Diagnosis Tube name Number of tubes Tube number Tube duration (day) P1 35 Male junior college Self-media Acute cholangitis /severe acute pancreatitis Nasobiliary drainage tube /Nasopancreatic drainage tube 2 2 31 P2 27 Male undergraduate Office clerk Acute suppurative cholecystitis/ Hypertriglyceride pancreatitis Nasobiliary drainage tube /Nasopancreatic drainage tube 2 1 35 P3 47 Female primary Farmer Choledocholithiasis Nasobiliary drainage tube 1 1 30 P4 48 Male high school Staff Acute biliary pancreatitis Nasopancreatic drainage tube/Gallbladder puncture tube 2 2 43 P5 39 Male undergraduate Office clerk Bile duct calculus with acute obstructive suppurative cholangitis Gallbladder puncture tube 1 1 34 P6 57 Female middle school Retirement Severe acute pancreatitis Nasopancreatic drainage tube 1 1 31 P7 46 Male primary Farmer Acute suppurative cholecystitis Gallbladder puncture tube 1 1 32 P8 46 Male primary Farmer choledocholithiasis Nasobiliary drainage tube 1 1 32 P9 56 Female primary None Acute suppurative cholecystitis Gallbladder puncture tube 1 1 36 P10 52 Male middle school None Severe acute pancreatitis /Acute suppurative cholecystitis Nasopancreatic drainage tube/Gallbladder puncture tube 2 1 38 P11 55 Female middle school None choledocholithiasis Nasobiliary drainage tube 1 1 32 P12 56 Female primary None severe acute pancreatitis Nasopancreatic drainage tub 1 1 43 P13 57 Male primary None hepatolithiasis T-tube 1 2 55 P14 61 Male high school Retirement severe acute pancreatitis Nasopancreatic drainage tub 1 1 31 P15 56 Male primary Worker severe acute pancreatitis Pancreatic puncture tube 1 1 62 P16 62 Female primary None Bile duct calculus Combined with suppurative cholecystitis Gallbladder puncture tube 1 1 34 P17 51 Male high school Individual Acute suppurative cholecystitis /Severe acute pancreatitis Nasobiliary drainage tube/Gallbladder puncture tube 2 3 35 Table 2 The patients’ experience of Out-of-hospital patients with drainage tube subject ranking table Theme Sub-theme Frequency constituent ratio Negative experiences in social life （ 26 ， 28.26% ） Patient role enhancement 11 64.7% Changes of work way 6 35.2% Changes of Lifestyle 9 52.9% Physical and mental discomfort （ 22 ， 23.91% ） Psychological negative experience 15 88.2% Physical negative experience 7 41.1% Lack of relevant knowledge of disease （ 17 ， 18.48% ） Lack of disease-related knowledge 8 47.0% Lack of nursing pipeline skills and weak awarenes 9 52.9% Hope for help （ 27 ， 29.35% ） Get a suitable drainage device 11 64.7% Perfect fixing tape and dressing 8 47.0% Improve the status of the subsequent visit 8 47.0% Total 92 2.2 The experience of placeing drainage tube with patients of biliary and pancreatic system disease The interview data of all interviewees were analyzed and categorized. Subsequently, four themes and ten sub-themes were integrated and sorted according to the frequency of the themes (Table 2). 2.2.1 Theme 1: Negative experiences in social life Among the patients, 28.26% had negative social life experiences (26, 28.26%), primarily characterized by the absence of a family role caused by strengthening the patient's role, followed by a change in work and lifestyle. Sub-theme 1: Patient role enhancement As patients carried drainage tubes outside the hospital and were in the transition period of recovery from the disease, clear role strengthening appeared at the psychological level, followed by the absence of family roles. For instance： P11 indicates: "I could not eat well with the nasal-tube every day, and fel t weak and forceless oftenly, can do nothing but lied down on the bed every day only"; P6 mentions: "The ability to do housework decreased and even became a burden, was treated as a serious patient by the family, did not allow me to do anything, it seems like a disabled person"; P8 describes: "I could not take care of the child for my daughter because she afraides the child would suddenly pull the tube." Sub-theme 2: Changes of work way Patients need long-term external drainage tube indwelling owing to treatment needs, which may result in varying degrees of self-image disorders and even an inability to participate in routine work and social activities. For instance, P10: "I could not work as before and quit the job, and now there was no income anymore, just can be at home every day.". Some patients used to be engaged in light physical labor, so they could continue to perform their previous work during carrying the drainage tube after discharged from hospital； P4 said: "My job is office management, so I could still work during the period of carrying the tube, but could not go out to socialize and I felt very distressed." Sub-theme 3: Changes of Lifestyle After illness and carrying drainage tube, patients often experience varying degrees of gastrointestinal function impairment, which manifests as poor digestive ability, poor appetite, and aversion to greasy food. Consequently, they are more inclined to choose a light diet that lacks protein and fat intake, resulting in nutritional deficiencies and losses. P4: "Dare not eat too greasy, after eating, I feel indigestion, accumulation of food"; P5: "When I smell the lampblack smell, will feel nauseous involuntarily." Simultaneously, extracorporeal drainage leads to the loss of most potassium and sodium electrolytes and digestive fluid, resulting in a decrease in the digestive function of patients and complications of electrolyte disorders. Therefore, it is recommended that patients with drainage tubes undergo routine biochemical examination every 2~3 days after discharge. The daily diet should include additional electrolytes. For patients undergoing extracorporeal drainage of pancreatic fluid with significant dyspepsia, additional oral administration of compound pancreatic enzyme tablets is required.. P16: "The doctor told me to eat salty meals, so I can't eat same meal with my family." 3.2.2 Theme 2: Physical and mental discomfort A total of 23.91% of the patients experienced physical and mental discomfort (22,23.91%), which was primarily manifested by negative psychological experiences, such as anxiety, fear, and family economic pressure, followed by negative physical experiences, including pain, oropharyngeal discomfort, and sleep disorders. Sub-theme 4: Psychological negative experience (1) Anxiety and fear: In the interview, when it was mentioned that there was still a long out-of-hospital home catheter, many patients stated that the doctor had informed them before the operation. However, when an actual home catheter was used, the patients and their families exhibited varying degrees of negative psychological coping states of anxiety and fear. For instance, P1 and P12: "Do not know how long the tube will take, can cure the disease or not?"; P2 and P3: "Afraid of this pipe fell, and I don’t know how to deal with it." P3, P4, and P15: "Home is far away from hospital, if there is problem happened how to deal with?." (2) Family economic pressure: During the transition treatment of external drainage tubes placed outside the hospital, patients not only need to bear the cost of surgical treatment and post-care but also require a special person to provide regular support during treatment, daily life, and drainage tube care. The family income source is reduced and requires high medical economic expenditures. This results in significant financial pressure on patients and their families, which not only leads to excessive psychological pressure but also causes the compliance of regular return to the doctor is low, and lead to serious complications due to it.. For instance, P16: "Every time my son has to ask for a day off to accompany me, the travel fee costs nearly 400 RMB." P4: "I don't make money now; it's too expensive to get sick." Sub-theme 5: Physical negative experience (1) Pain and limited activity: This theme is present in the patient groups of "gallbladder puncture drainage tube" and "pancreatic puncture drainage tube." The puncture pipe is rigid and cannot completely fit the skin, resulting in shaking of the pipe owing to clothing and pain caused by changes in the body position. P5, P8, and P15: "I feel that the knife edge of the tube hurts"; P15: "Every time the tape is loosened, the pipe moves up and down with the clothes, which makes the wound uncomfortable and painful strongly"; P5, and P9: "Every time I lie down, the back of the lumbar cavity pierced by this tube hurts"; P9: "I dare not turn to the right side when sleep, I feel that I have poked my liver by the tube." (2) Oropharyngeal discomfort and restricted breathing: This theme is present in the "nasobiliary drainage tube" and "nasopancreatatic drainage tube" patient groups. The tube was inserted retrogradely through the oropharyngeal passage from the nose. Oral breathing has become the primary method for relieving throat irritation, and most patients use body language to reduce pharyngeal activity to avoid pharyngeal stimulation. During the interview, when asked questions that did not appear, the patients answered by shaking heads and waving hands. P12: "It’s very easy to get nausea with this tube, after taking a few deep breaths will be better." P11: "There is sore throat greatly during talk because of taugh tube, and generally speaks little." P17: "Wearing this tube it’s easy to be nauseous, specially during brushing teeth and coughing." (3) Sleep disorders: The sleep quality experienced by patients at night has a significant impact. The majority of patients were concerned about the tubes and feared pulling the tube during sleep, leading to unplanned extubation and resulting in multiple night awakenings to check the pipeline, which leads to sleep disruption and poor sleep quality at night in patients and their family members. P10: "I always worry about the tube will be pressed or pulled by mistake during sleep, and experience sleep disruption oftenly. So I feel dazed and hypodynamic at daytime." P6: "I am afraid that my husband will accidentally pull out the tube during sleep, so I have been sleeping alone." 2.3 Theme 3: Lack of relevant knowledge of disease There were 18.48% of patients with a lack of relevant knowledge (17, 18.48%), which mainly manifested as a lack of disease-related knowledge, followed by a lack of nursing pipeline knowledge and weak consciousness of tube nursing. Sub-theme 6: Lack of disease-related knowledge Even if doctors provide relevant disease knowledge and health guidance upon discharge, patients have little understanding owing to different educational levels, memory loss or bias over time, and other problems (Wang et al,2019). Furthermore, patients exhibit varying degrees of cognitive differences in disease-related knowledge, resulting in weak compliance. Patients have a significantly increased risk of drainage complications and adverse events, and even drainage fluid develops a white pus coloration accompanied by fever for several days without emergency medical attention. P16: "The liquid used to be brown, but now it's white. Sometimes the color is dark, sometimes light, do not know is normal or not?" P8: "Before the flow is more than 200 ML, now there is only 50 ML." Sometimes the flow is less whole day, is everything okay?" Some patients do not pay much attention to the progress of the disease and rehabilitation and only care about self-feeling and economic expenditure. P9: "The biggest concern is when can pull out the tube from my body, and it cost a lot of money for backing visit the doctor every time." Sub-theme 7: Lack of nursing pipeline skills and weak awareness The nurse in charge provided education on pipeline nursing knowledge upon discharge from the hospital, and the hospital established a pipeline nursing clinic to provide pipeline nursing to patients with out-of-hospital pipes. However, because of the patients' insufficient attention and weak awareness of pipeline nursing, they did not return to the hospital in time to reduce economic pressure, which led to the loosening of the fixation of the indwelling end in vitro and caused complications, such as skin infection around the incision, pipeline blockage, and even slip. P9: "The tape can not stick; I have no choice but to put a Band-aid on it."; P10: "The tube on the nose is too thin, wear for a long time, and accidentally discounted several places; I don't know whether the tube is still wroking or not?"; P15: "The skin around this tube itches every time when I sweat, which is really uncomfortable." 2.4 Theme 4: Hope for help The patients (27, 29.35%) were positive regarding surgical treatment and rehabilitation, eager to recover as soon as possible, and eager to optimize specific problems existing during the canalization process to obtain assistance from medical staff, for instance, obtaining a suitable drainage device, improving the fixed tape and dressing, and improving the return visits. Sub-theme 8: Get a suitable drainage device With the increase in drainage time and the recovery of the disease, the drainage fluid will gradually decrease. Hoping to obtain a smaller bag and shorten the length of the drainage bag pipe. P5: "Now there is not much drainage fluid, only 30-40ml a day; I hope to get a small bag; it is too troublesome to carry such a big bag."; P14: "Each time this tube has to go around many times, too long, it’s too troublesome." Sub-theme 9: Perfect fixing tape and dressing This theme appeared in the patient groups of "gallbladder puncture drainage tube" and "pancreatic puncture drainage tube." Patients have puncture wounds in the abdomen, which should be kept dry, and the dressing should be kept clean. Adhesive tape mark and body dirt are produced during the tube application, and patients have the strong request of batheing. P1: "I can not take a bath, my body is sticky everywhere,it’s too uncomfortable"; P4: "Is there something waterproof tape and can protect the wound from the water? Let me take a bath comfily." Sub-theme 10: Improve the status of the subsequent visit Some patients need to take 6 to 7 hours by bus for further visits to hospital, the review waiting time is longer, and they are eager to review or replace the pipeline in the local hospital. P7: "Each round trip cost nearly 400 RMB, and takes too much time, the whole day is on the way ." P15: "My home is far away from the hospital, when finish the review the disease, and the bus of backing home is finished,. It’s very inconvenience." Discussion 3.1 Patients of biliary and pancreatic system diseases with tube at out-of-hospital have obvious social negative experiences and need more family care, support, and social acceptance Negative social experiences refer to the unpleasant things we encounter in our lives and cause us to have negative emotional experiences (Zhou et al, 2024). Negative social experiences are the risk factor for the sub-health of residents and can directly affect health status. The findings of this study indicate that the frequency of negative social experiences was 26, accounting for 28.26% of all catheter experiences, which was the first problem encountered by patients with external ducts in hepatobiliary and pancreatic hospitals. The most significant factors were the strengthening of patient roles and the absence of family roles (64.7%). Such patients often need to carry external drainage tubes outside the hospital due to treatment needs. In this study, the out-of-hospital with tube duration was (37±8.9) days. Because of the patient's nervousness about the medical decision of "out-of-hospital with tube" and worry about recovery from the disease, as well as the lack of knowledge and skills in pipeline nursing, patient was in a state of role strengthening for a long time at home. This leads to the long-term absence of family and social roles, making it difficult to return to society in later stages. Simple aerobic activities and exercises after discharge are also conducive to the early recovery of patients. The Outline of "Healthy China 2030" issued by The State Council "(CPC,2020) clearly points out that it is necessary to adjust and optimize the health service system, meet the health needs of the people, and enhance the sense of medical experience. Therefore, for such patients, medical staff should actively provide extended care services and follow-up management for patients with discharge and management and encourage the transformation of patients' roles to family and society. Second, the average age of participants in this study was 50 ± 9.4 years. Individuals in this age group generally play the role of mainstays in the family. However, out-of-hospital tubes prevent them from participating in routine work and life, and they may even be compelled to stop working to concentrate on their recovery from illness, which also has different degrees of impact on the work and lifestyle of a family. The patient could no longer participate in physical labor, even simple housework, because of physical discomfort and retention of the drainage tube. They and their families take care of the protection of the drainage tube and make the patient give up activities or work within their capacity. Therefore, in view of the problem of patients' heightened or diminished roles, medical staff should improve communication with patients and their families, assist patients in reestablishing appropriate and positive family and social roles, and perform simple housework activities, such as sweeping the floor, picking dishes within their capacity, prioritizing the family, starting with family empowerment, and encouraging family members to provide patients with more psychological family support. Try to reduce the impact of negative social experiences on patients caused by the role of out-of-hospital care. 3.2 Patients with out-of-hospital ducts for biliary and pancreatic system diseases have obvious physical and mental discomfort experience, and the body coping style should be appropriately adjusted to reduce complications Patients with postoperative indenturement ducts for biliary and pancreatic system diseases cannot adapt to the influence of the body, and some physiological functions are limited, consistent with the findings of Zhou et al. (Zhou et al, 2015). Studies have demonstrated that preoperative adaptive nasal blocking and breathing training can enhance the adaptability and endurance of patients (Ren er al,2010). The discomfort experience can be alleviated by adjusting the breathing mode, reducing the stimulation of the restricted part, and altering the body position. Therefore, it is recommended that nurses guide patients on the appropriate use of breathing and swallowing techniques before surgery to prevent coughing during breathing and eating and to reduce oropharyngeal discomfort. Concurrently, medical staff should focus on the psychological assessment of patients in clinical work, monitor psychological and emotional changes during hospitalization, promptly identify and adjust negative concepts, and alleviate patients' negative emotions and concerns. Furthermore, it strengthens communication with family members, pays attention to the psychological experience of patients, promotes positive expression, timely solving patients' demands, and significantly helps patients solve physical and mental discomfort. Accidental extubation, extubation, internal displacement of the tube, and other complications are more traumatic for patients, necessitating another operation, are not conducive to the recovery of patients with tubes, can aggravate their condition, and may even result in death (Cosentino et al,2017). Establish a consultation hotline or patient friend WeChat group, regular telephone follow-up, and patient friend discussion to ensure that patients can receive guidance at any time, provide patients with accurate information support and healthy life guidance, and urge patients to carry out pipeline care and follow-up visits to reduce unplanned extubation and complications and promote patients' recovery. 3.3 Patients with biliary and pancreatic system diseases lack knowledge about diseases and drainage tube nursing, so education and science popularization outside hospitals should be strengthened to improve their sense of catheter experience Knowledge reserves are the internal motivations for behavior improvement. Some studies have demonstrated that the coping ability of patients receiving home nasal feeding treatment is closely associated with the quantity and quality of acquired knowledge (Serjeant et al,2022). Sufficient knowledge is a prerequisite for a smooth transition to tube feeding and everyday life, which has a synergistic effect with the poor tube experience of patients in this study due to a lack of knowledge and skills about diseases and drainage tube nursing (Strolloet al,2017). Currently, with the continuous expansion and improvement of the health education model, the self-care experiential health education model is a novel educational model for improving the mastery of relevant nursing skills and the self-care ability of patients through situational experience (Zhang et al,2022). Some scholars have applied this model to the health education of patients with closed thoracic drainage tubes, and the results have revealed a significant improvement in the self-care ability and self-efficacy of patients (Zhang et al,2019). There was study (Peng et al,2022) adopted Internet + extended care for patients with T-tubes outside the hospital, and the results demonstrated that it could significantly improve patients' self-care ability and reduce the complication rate. Therefore, nursing staff should take responsibility for disseminating relevant knowledge, strengthening communication with patients and their families, and accurately assessing the extent to which patients possess knowledge of disease and self-management. ①Multi-form and multi-dimensional health education activities can be used to provide a new type of health education oriented by patients and their families, and appropriate self-care experiential or real experience health education with drainage tubes outside the hospital can be carried out to improve patients' knowledge of relevant nursing skills. ②Establishing a consultation hotline or WeChat group and regular phone follow-up to ensure patients can receive guidance anytime. Patients should be provided with accurate information, support, and guidance for a healthy life and encouraged to participate in pipeline care and follow-up visits. They should also be assisted in establishing a correct lifestyle with tubes, which will improve their quality of life and treatment effects. ③Combined with the development of the Internet and artificial intelligence at this stage, the use of platforms such as WeChat public account, Douyin, and micro video enabled the development of new forms of health education and popular science, created vivid educational content and improved their mastery of disease-related knowledge and nursing skills. 3.4 For patients with the out-of-hospital duct of biliary and pancreatic system diseases, the subsequent hardware configuration of home treatment needs to be further improved According to Maslow's hierarchy of needs (Li et al,2019), physiological needs are the most basic needs of the human body, including breathing, food, water, sleep, and physiology. However, this study indicated that the medical decision regarding out-of-hospital tubes has a certain impact on the most basic physiological needs of patients. Several participants mentioned that shower demand during tube wearing could not be guaranteed, and they hoped to have water-resistant fixed devices. Currently, our center uses 3M tape (nose tape and I-script tape, Figure 1) for external fixation of patients carrying drainage tubes, guaranteeing a certain fixation effect within 3～5 days. In contrast, the average time of patients with out-of-hospital tubes is (37±8.9) days. Patients cannot buy well-matched 3M tape fixations outside the hospital, resulting in poor fixation of out-of-hospital tubes. Due to the high incidence of out-of-hospital catheterization, hospitals can communicate and negotiate with relevant departments, refer to the out-of-hospital management strategy for patients with ostomy, and provide out-of-hospital tube care packages for patients discharged from the hospital with tubes, including anti-reflux screw drainage bags, iodophor disinfection swabs, multiple 3M fixed adhesive tapes, and videos guiding the replacement of drainage bags at home. Medical personnel can also innovate and improve existing devices in this direction and apply them for related patents. Establishing multiple communication channels to ensure patients receive guidance at any time is also possible. In addition to teaching patients and their families about the care of pipes and wounds, provincial hospitals can provide relevant training to medical personnel, including county-level hospitals, township health centers, and community medical service stations. They can also establish corresponding connectivity networks or referral services to ensure patients receive standardized care nearby and reduce complications caused by improper pipe or wound care or timely treatment. Conclusions Patients with postoperative biliary and pancreatic system diseases with catheters experience varying degrees of stress. Patients encounter numerous challenges during out-of-hospital with drainage tube, including physiological adaptation and disease rehabilitation. This study conducted qualitative interviews on the tube experience of 17 patients with biliary and pancreatic system diseases. The findings indicated that patients exhibited negative social life experiences and physical and mental discomfort during carrying the drainage tube after discharge from hospital. Targeted health education and continuous nursing are necessary to maximize patients' self-care abilities, reduce canal-related complications and anxiety, and improve their quality of life. However, this study has some limitations. The interviewees had regional problems, and the living standards and cultural differences between different regions had an impact on the main feelings of patients. Consequently, the results obtained applied to the entire population of this region. Declarations FUNDING This work was supported by the 2023 Ningxia Natural Science Foundation General Project (2023AAC03622)；2023 Autonomous Region Health System Research Project Youth Science and Technology Cultivation Project (2023-NWKYP-052); Ningxia Medical University General Hospital young backbone medical talent project This research received no specific grant from any funding agency,commercial or not-for-profit sector. CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest or financial disclosures related to this research study. This study was conducted in accordance with ethical guidelines and all necessary approvals were obtained before its commencement. DATA AVAILABILITY STATEMENT The datasets generated during and/or analysed during the current study are available from the first author and corresponding author on reasonable request. The data are not publicly available due to restrictions [e.g. their containing information that could compromise the privacy of research participants]. References Balduino AF, Mantovani MF, Lacerda MR, Marin MJ, Wal ML. Experience of hypertensive patients with self-management of health care. J Adv Nurs. 2016 Nov;72(11):2684-2694. http://doi: 10.1111/jan.13022. Epub 2016 Jun 13. PMID: 27206159. Chen Y, WANG H, ZHU Q, et al(2019). Research progress of inpatient experience. J Nurs Adminis,20(3):189-194. (in Chinese) http://doi:10.3969/j.issn.1671-315x. 2020.03.009. CPC Central Committee and State Council(2016). Outline of Healthy China 2030 [EB/OL]http://www.gov.cn/zhengce/2016-10/25/content5124174.htm Cosentino C, Fama M, Foà C, et al(2017). Unplanned Extubations in Intensive Care Unit: evidences for risk factors. A literature review. Acta Biomed.Nov 30;88(5S):55-65. http://doi:10.23750/abm.v88i5-S.6869. PMID: 29189706; PMCID: PMC6357578. Guo H, Zhang L, He H, et al(2024). Risk factors for catheter-associated bloodstream infection in hemodialysis patients: A meta-analysis. PLoS One. Mar 27;19(3):e0299715. http://doi: 10.1371/journal.pone.0299715. PMID: 38536779; PMCID: PMC10971780. Liu Z(2017). Clinical effect of retrograde endoscopic cholangiography biliary stent implantation and percutaneous transhepatic puncture in the treatment of malignant obstructive jaundice. Chin J Clini Oncology,33(11):1030-1034. http://doi:10.3760/cma.j.issn.1008-6315.2017.11.017. Liao X, Zhou W(2022). Application value of endoscopic nasobiliary drainage in ERCP. J Lanzhou University (Medical Edition),48(2):87-91.http://doi:10.13885/j.issn.1000-2812.2022.02.017. Liu H(2023). 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The Effect of Enteral Tube Feeding on Patients' Health-Related Quality of Life: A Systematic Review. Nutrients. 2019 May 10;11(5):1046.http://doi: 10.3390/nu11051046. PMID: 31083338; PMCID: PMC6566785. Peng Y, Wan H, Hu X, et al(2022). Internet+Continuous Nursing Mode in Home Nursing of Patients with T-Tube after Hepatolithiasis Surgery. Comput Math Methods Med. 2022 May 31;2022:9490483. http://doi: 10.1155/2022/9490483. PMID: 35685900; PMCID: PMC9173949. Qi Q, Fei X, Chen Y, et al(2019). Qualitative study of life experience with tube in patients with malignant obstructive jaundice after percutaneous hepatic puncture biliary drainage. Shanghai Nurs,2019,24(05):11-16. http://:10.3969/j.issn.1009-8399.2024.05.003. Rizzo A, Ricci AD, Frega G, et al(2020). How to Choose Between Percutaneous Transhepatic and Endoscopic Biliary Drainage in Malignant Obstructive Jaundice: An Updated Systematic Review and Meta-analysis. In Vivo. 2020 Jul-Aug; 34(4):1701-1714. http://doi: 10.21873/invivo.11964. Ren L(2010). Observation on the effect of nasal plugging training before nasal endoscopy on pain relief of postoperative patients. Inner Mongolia Tradi Chin Med,29(11):3-4. http://doi:10.16040/j.cnki.cn15-1101.2010.11.141. Serjeant S, Tighe B(2022). A meta-synthesis exploring caregiver experiences of home enteral tube feeding. J Hum Nutr Diet.Feb;35(1):23-32. http://doi: 10.1111/jhn.12913. Epub 2021 May 25. PMID: 33934418. Strollo BP, McClave SA, Miller KR(2017). Complications of Home Enteral Nutrition: Mechanical Complications and Access Issues in the Home Setting. Nutr Clin Pract. Dec;32(6):723-729. http://doi: 10.1177/0884533617734529. PMID: 29927520. Wang L, Gu X, Zhang Y, et a(2019)l. Qualitative study on the real experience of patients with tunnel PICC catheterization. J Nurs,28(16):58-62. http://DOI:10.16460/j.issn1008-9969.2021.16.058. Wang L, Zhang X, Liu Y, et al(2019). Qualitative study on home self-management of chronic hepatitis B patients with diabetes mellitus.J General Nurs, 2019,20(29):4039-4043. Xu B, Chen Z, Lin S, et al(2020). Clinical value of ERCP or ERCP combined with PTCD common duct stent for biliary drainage in the treatment of malignant obstructive jaundice. Chin J Gerontology,40(15):3218-3221. http://doi:10.3969/j.issn.1005-9202.2020.15.027. Zhou H, Yang Sh, Han D, et al(2024). Relationship between family dynamics and negative life events and depressive symptoms in adolescents. Chin J PLA Med,2024,1-8.http://kns.cnki.net/kcms/detail/11.1056.r.20240518.1510.002.html. Zhou S, Wu Q, Li W, et al(2015). Effect of drug spray on oral, nasal and throat comfort and complications in patients with indentation of nasobiliary duct. Chin J Nurs,2015,50(04):479-481.http://doi:10.3761/j.issn.0254-1769.2015.04.023. Zhang Q, Zhang X, Wu Y, et al(2022). Application effect of health education model based on real experience in rehabilitation nursing of stroke patients. J Nurs Research,36(11):2038-2041.http://DOI:10.12102/j.issn.1009-6493.2022.11.030. Zhang Y, Zhang Y, Wei X(2019). Application of experiential health education of chest tube self-care in patients with pulmonary nodule resection. Chin J Emer Resus and Disaster Med,,19(03):383-386+413.http://doi:10.3969/j.issn.1673-6966. 2024.03.024. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 14 Oct, 2025 Read the published version in BMC Gastroenterology → Version 1 posted Editorial decision: Revision requested 18 Oct, 2024 Editor assigned by journal 18 Oct, 2024 Submission checks completed at journal 10 Oct, 2024 First submitted to journal 09 Oct, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5235404","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":364782515,"identity":"137423ba-21ad-437c-a1ab-4e9d44132ed8","order_by":0,"name":"Jingli LIU","email":"","orcid":"","institution":"General hospital of Ningxia Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jingli","middleName":"","lastName":"LIU","suffix":""},{"id":364782516,"identity":"fe4e6b6d-c655-4371-be23-e06e8f4961f2","order_by":1,"name":"Qianqian WANG","email":"","orcid":"","institution":"General hospital of Ningxia Medical University","correspondingAuthor":false,"prefix":"","firstName":"Qianqian","middleName":"","lastName":"WANG","suffix":""},{"id":364782517,"identity":"ca217f64-cbf4-4e29-ace5-28ee9cbc34c1","order_by":2,"name":"Xiaoping YE","email":"","orcid":"","institution":"General hospital of Ningxia Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xiaoping","middleName":"","lastName":"YE","suffix":""},{"id":364782518,"identity":"e34fbeca-46e5-408c-9b6e-4606579c44a5","order_by":3,"name":"Lixia Xie","email":"","orcid":"","institution":"General hospital of Ningxia Medical University","correspondingAuthor":false,"prefix":"","firstName":"Lixia","middleName":"","lastName":"Xie","suffix":""},{"id":364782519,"identity":"b5992096-d763-47b4-b97d-8c7e1fa2e4c1","order_by":4,"name":"Ziyu WU","email":"","orcid":"","institution":"General hospital of Ningxia Medical University","correspondingAuthor":false,"prefix":"","firstName":"Ziyu","middleName":"","lastName":"WU","suffix":""},{"id":364782520,"identity":"7ab46de6-a6a4-4bac-916c-defcb97dc55f","order_by":5,"name":"Doudou HUANG","email":"","orcid":"","institution":"Ningxia Medical University","correspondingAuthor":false,"prefix":"","firstName":"Doudou","middleName":"","lastName":"HUANG","suffix":""},{"id":364782521,"identity":"ff52b796-dafe-4d5d-8818-3c03573e3585","order_by":6,"name":"Yanrong YAO","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7klEQVRIiWNgGAWjYHADxoYDCRUScvIkaGFuPPDhjIWxYQPxWtibD85sq0hkOEBAncHxw8ckfu64J2fOv7DhMO88iQTGBuaHj27g03ImLU2y90yxseWMh0At2yTy2BnYjI1z8Gk5kGMmwduWkLjhxkGwlmLGBh42abxazr8xk/wL1zJHIrHhACEtN3LMpMG2nG9sODizgQgtkjeeJVvLtiUYG9wAxsuHYxLGhs0E/MJ3PvngzbdtCXIG548//pBQUycnz9788DE+LQoHGFgkwCyJBKgQMx7lICDfwMD8AcziP0BA6SgYBaNgFIxYAADdiFcGsigX0AAAAABJRU5ErkJggg==","orcid":"","institution":"General hospital of Ningxia Medical University","correspondingAuthor":true,"prefix":"","firstName":"Yanrong","middleName":"","lastName":"YAO","suffix":""}],"badges":[],"createdAt":"2024-10-10 00:53:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5235404/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5235404/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12876-025-04317-9","type":"published","date":"2025-10-14T15:57:05+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":67263744,"identity":"ce4b4759-fa35-4350-9688-b36169a3b9c6","added_by":"auto","created_at":"2024-10-23 06:26:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":207327,"visible":true,"origin":"","legend":"\u003cp\u003eNose tape and I-script tape\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5235404/v1/9942c96b5abfd0e2e8c9ad0b.png"},{"id":93955995,"identity":"cdc2e77a-871a-4704-acfb-af2288a96222","added_by":"auto","created_at":"2025-10-20 16:08:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1754028,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5235404/v1/dff0c239-3e5f-4735-8d23-ab60e93d4221.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Qualitative study of experience of patients with external drainage tube out of hospital with biliary and pancreatic system diseases","fulltext":[{"header":"Introduction","content":"\u003cp\u003eWith the continuous development of various treatment technologies and progress in minimally invasive diagnostic and therapeutic strategies, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography and drainage (PTCD), endoscopic nasobiliary drainage (ENBD) (Liu,2017; Liao et al, 2022), and other minimally invasive endoscopic approaches have become the preferred treatment for biliary and pancreatic diseases (Liu et al,2023). After treatment, it is necessary to place external drainage tubes, including nasobiliary/pancreatic drainage tubes, biliary/gallbladder puncture drainage tubes, and peripancreatic puncture drainage tubes to alleviate obstruction of the biliary and pancreatic systems, reduce local exudation of organs (Xu et al,2020), and achieve adequate drainage and disease treatment. External drainage tubes are often necessary to be placed for two weeks to three months(Peng et al,2022). Patients frequently face out-of-hospital medical decisions with drainage tubes. Although most patients were in stable condition after discharge, their physical function did not fully recover, and they were in a transitional state of recovery.\u003c/p\u003e\n\u003cp\u003eThe incidence of complications related to the out-of-hospital catheter was as high as 17.2%\u0026ndash;39.5%, mainly including skin rupture around the puncture point, pipeline blockage, unplanned extubation, extubation or displacement, infection, and other complications(Rizzo et al,2020). Physical and psychological effects on patients and their families have varying degrees (Qi et al,2019), seriously affecting the quality of life. Patient experience refers to the psychological feelings of patients during the medical treatment and nursing process and the experience of the details of the entire process(Chen et al,2019). Relevant studies on patient experience have mainly focused on the postoperative experience of patients with breast cancer (Mei et al, 2019) and chronic disease self-management experience[(Balduino et al, 2016). Currently, only a few studies have focused on the patients\u0026rsquo; experience of patients with peripherally inserted central catheter(PICC)(Wang et al, 2019) and enterostomy out-of-hospital (Liu et al, 2022). The findings revealed that patients often have a decline in quality of life, restrictions on social activities, changes in body image (Guo et al, 2024), and even adverse events such as infection and tube blockage (Ojo et al, 2019). However, there are few reports on the tube experience of patients with external drainage tubes outside the hospital. Consequently, this study aimed to understand the experiences of patients with external drainage tube outside hospital with biliary and pancreatic system diseases through qualitative research to provide a theoretical basis and reference for formulating nursing intervention measures based on the actual experiences of patients with ducts.\u003c/p\u003e"},{"header":"OBJECTS AND METHODS ","content":"\u003cp\u003e\u003cstrong\u003e1.1 Research object\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe objective sampling method was used to select patients as study participants who were admitted to the Department of Hepatobiliary Surgery and Pipeline Nursing Outpatient Department of a triple A hospital in Yinchuan City,\u0026nbsp;Ning Xia province, China,\u0026nbsp;from December 2023 to March 2024 and had external drainage tubes in place outside the hospital for more than one month.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria were as follows: ①patients aged 18\u0026ndash;65 years; ②patients with out-of-hospital catheters for \u0026gt; 1 month; ③patients who knew the condition were willing to participate in the interview under informed conditions and had good communication skills.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe exclusion criteria were as follows: ①Patients with malignant tumors. Patients with drainage tubes were placed based on the concept of palliative care; ②the disease suddenly worsened during the indwelling tube. This study was reviewed by the Research Ethics Committee of the General Hospital of Ningxia Medical University (Ethics number: KYLL-2022-1341). All participants voluntarily participated in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.2 Survey Tools\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.2.1 Formulation of the first draft of the interview outline\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWith \u0026quot;nasobiliary drainage tube\u0026quot;, \u0026quot;PTCD\u0026quot;, \u0026quot;percutaneous hepatobiliary puncture\u0026quot;, \u0026quot;T tube\u0026quot;, \u0026quot;patient experience\u0026quot;, \u0026quot;out-of-hospital catheter\u0026quot;, \u0026quot;home catheter\u0026quot; and \u0026quot;catheter experience\u0026quot; as search terms were used to search and retrieve relevant literature in PubMed, China National Knowledge Infrastructure(CNKI), Wanfang Medical Network, and other databases, to summarize the literature, and to form the first draft of the interview outline.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.2.2 Formation of the final interview outline\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTwo subjects meeting inclusion and exclusion standards were selected for the pre-interview, and the final interview outline was prepared after discussion and revision by the research team. The final draft was as follows:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e①What is your first feeling when you learned that you need to carry drainage tube for some time after discharged?\u003c/p\u003e\n\u003cp\u003e②What is the biggest trouble for you with the drainage tube outsied hospital?\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e③What are your biggest concerns during tube drainaging out of hospital?\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e④What impact does place drainage tube during the out-of-hospital have on your life and work?\u003c/p\u003e\n\u003cp\u003e⑤What kind of help do you want to get during drainage after discharge from medical staff?\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.3 Conducting interviews\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.3.1 Preparation before interview\u003c/strong\u003e\u0026nbsp; \u0026nbsp;①Patient preparation: Interviews were conducted with patients in the Pipeline Nursing Outpatient Department of the a triple A hospital in Yinchuan after the appointment with consent. ②Goods preparation: One voice recorder, one notebook (to record body language, such as expression, tone, and mood change), one pen, one general interview data sheet, and some interview record charts. ③Environmental preparation: This should be carried out in a place with sufficient light and a quiet environment, and the time is generally selected after the patient\u0026apos;s treatment finished.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe interview site of this study was a corridor next to the Pipeline Nursing Outpatient Department of a triple A hospital in Yinchuan City, Ning Xia province, China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.3.2 Conducting formal interviews\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were collected through semi-structured interviews and observations. Before the interviews, the researcher explained the purpose, content, and process of the research in detail to the interviewees and ensured that the interview content was only for academic research. The entire process was recorded with the consent of the interviewees. 1～2 patients were interviewed each time, each for 20～40 min. Focus on the interview content according to the outline, but do not stick to it. Using interview skills such as listening, summarizing, induction, verification, and repetition encourage patients to express their true feelings and opinions. Concurrently, it is necessary to take interview notes and record the non-body language, such as complexion, micro-expression, intonation changes, and mood fluctuations and so on. Appropriate follow-up questions were asked based on the patient\u0026apos;s answers to obtain more detailed and comprehensive information during the interviews. Should be avoid seductive questions and listen patiently\u0026nbsp;during the interviews.\u003c/p\u003e\n\u003cp\u003eIf patients occur sudden emotional agitation or discomfort during the interview, it should be immediately suspended or ended. According to the principle of saturation in qualitative research data collection, three to four patients were continued to be interviewed after no new topics appeared until their main problems were identified. Finally, 17 patients were interviewed in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.4 Data collection and analysis\u003c/strong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData collection and analysis were performed simultaneously. The interview data were processed anonymously, and the names of the interviewees were replaced with numbers from P1 to P17. The interview contents were sorted out and analyzed within 24 hours after the interview First, the data from the recorded interviews were transcribed word by word and analyzed using the seven-step method of Colaizzi phenomenology(Liu,2008). The data analysis process was completed independently and simultaneously by two researchers and the controversial contents were discussed with the members of the research group and reached a consensus.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.5 Theme integration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u0026nbsp; \u0026nbsp; Data content was coded and classified, and similar content was summarized and organized to form themes and sub-themes. Finally, the extracted topics and subtopics were sorted according to their frequency of occurrence.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.6 Quality control \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBefore the interview, the researcher communicated with the patient to ensure the interview participants were familiar with and trusted the researcher. It was necessary to reveal their true feelings during interviews. The researcher has received training related to qualitative research, and the researcher and the Pipeline Outpatient Specialist Nurses provide relevant nursing services and health guidance to build a friendly and trusting relationship with the patients and to ensure the credibility of the obtained data from object of study. The researcher did not make any judgments about the interview content of the participants during the interview. The recording content was converted into a manuscript within 24h of the interview. If the transcript was inaccurate for patients who used dialects, the researcher retrospectively transcribed the recording file manually. When there are questions or uncertain information, confirm the information with the interviewee as necessary.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003e2.1 General information of research objects\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study included 17 patients (11 male and 6 female patients). The mean patient age was (50 \u0026plusmn; 9.4) years, and the mean duration of catheter placement time was (37 \u0026plusmn; 8.9) days. And there were nasobiliary drainage tubes, gallbladder puncture drainage tubes, nasopancreatic drainage tubes, pancreatic puncture drainage tubes, and T tubes (Table 1).\u003c/p\u003e\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"930\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" style=\"width: 930px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1 General data table of patients with drainage tube out-of-hospital (n=17)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNO\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(year)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation background\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTube name\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of tubes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTube number\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTube duration\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(day)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003ejunior college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eSelf-media\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eAcute cholangitis\u003c/p\u003e\n \u003cp\u003e/severe acute pancreatitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasobiliary drainage tube\u003c/p\u003e\n \u003cp\u003e/Nasopancreatic drainage tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eundergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eOffice clerk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eAcute suppurative cholecystitis/\u003c/p\u003e\n \u003cp\u003eHypertriglyceride pancreatitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasobiliary drainage tube\u003c/p\u003e\n \u003cp\u003e/Nasopancreatic drainage tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eCholedocholithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasobiliary drainage tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003ehigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eStaff\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eAcute biliary pancreatitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasopancreatic drainage tube/Gallbladder puncture tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eundergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eOffice clerk\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eBile duct calculus with acute obstructive suppurative cholangitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eGallbladder puncture tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003emiddle school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eRetirement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eSevere acute pancreatitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasopancreatic drainage tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eAcute suppurative cholecystitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eGallbladder puncture tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003echoledocholithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasobiliary drainage tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eAcute suppurative cholecystitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eGallbladder puncture tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003emiddle school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eSevere acute pancreatitis\u003cbr\u003e\u0026nbsp;/Acute suppurative cholecystitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasopancreatic drainage tube/Gallbladder puncture tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003emiddle school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003echoledocholithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasobiliary drainage tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003esevere acute pancreatitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasopancreatic drainage tub\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003ehepatolithiasis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eT-tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003ehigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eRetirement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003esevere acute pancreatitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasopancreatic drainage tub\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eWorker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003esevere acute pancreatitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003ePancreatic puncture tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eprimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eBile duct calculus\u003cbr\u003e\u0026nbsp;Combined with suppurative cholecystitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eGallbladder puncture tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 50px;\"\u003e\n \u003cp\u003eP17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003ehigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003eIndividual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 174px;\"\u003e\n \u003cp\u003eAcute suppurative cholecystitis\u003c/p\u003e\n \u003cp\u003e/Severe acute pancreatitis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003eNasobiliary drainage tube/Gallbladder puncture tube\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3825%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.4564%;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" style=\"width: 873px;\"\u003e\n \u003cp\u003eTable 2 \u0026nbsp;The patients\u0026rsquo; experience of Out-of-hospital patients with drainage tube subject ranking table\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 251px;\"\u003e\n \u003cp\u003eTheme\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003eSub-theme\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003econstituent ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 251px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative experiences in social life\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e26\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003e28.26%\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003ePatient role enhancement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e64.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003eChanges of work way\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e35.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003eChanges of Lifestyle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e52.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 251px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical and mental discomfort\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e22\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003e23.91%\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003ePsychological negative experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e88.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003ePhysical negative experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e41.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 251px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLack of relevant knowledge of disease\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e17\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003e18.48%\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003eLack of disease-related knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e47.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003eLack of nursing pipeline skills and weak awarenes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e52.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 251px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHope for help\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e27\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003e29.35%\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003eGet a suitable drainage device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e64.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003ePerfect fixing tape and dressing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e47.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 304px;\"\u003e\n \u003cp\u003eImprove the status of the subsequent visit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e47.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 555px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 187px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 The experience of placeing drainage tube with patients of biliary and pancreatic system disease\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe interview data of all interviewees were analyzed and categorized. Subsequently, four themes and ten sub-themes were integrated and sorted according to the frequency of the themes (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2.1 Theme 1: Negative experiences in social life\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Among the patients, 28.26% had negative social life experiences (26, 28.26%), primarily characterized by the absence of a family role caused by strengthening the patient\u0026apos;s role, followed by a change in work and lifestyle.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-theme 1: Patient role enhancement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs patients carried drainage tubes outside the hospital and were in the transition period of recovery from the disease, clear role strengthening appeared at the psychological level, followed by the absence of family roles. \u0026nbsp;For instance：\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11 indicates: \u0026quot;I could not eat well with the nasal-tube every day, and fel\u003cu\u003et\u003c/u\u003e weak and forceless oftenly, can do nothing but lied down on the bed every day only\u0026quot;;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6 mentions: \u0026quot;The ability to do housework decreased and even became a burden, was treated as a serious patient by the family, did not allow me to do anything, it seems like a disabled person\u0026quot;;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP8 describes: \u0026quot;I could not take care of the child for my daughter because she afraides the child would suddenly pull the tube.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-theme 2: Changes of work way\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients need long-term external drainage tube indwelling owing to treatment needs, which may result in varying degrees of self-image disorders and even an inability to participate in routine work and social activities. For instance,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \u0026quot;I could not work as before and quit the job, and now there was no income anymore, just can be at home every day.\u0026quot;.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSome patients used to be engaged in light physical labor, so they could continue to perform their previous work during carrying the drainage tube after discharged from hospital；\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP4 said: \u0026quot;My job is office management, so I could still work during the period of carrying the tube, but could not go out to socialize and I felt very distressed.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-theme 3: Changes of Lifestyle\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter illness and carrying drainage tube, patients often experience varying degrees of gastrointestinal function impairment, which manifests as poor digestive ability, poor appetite, and aversion to greasy food. Consequently, they are more inclined to choose a light diet that lacks protein and fat intake, resulting in nutritional deficiencies and losses.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP4: \u0026quot;Dare not eat too greasy, after eating, I feel indigestion, accumulation of food\u0026quot;;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5: \u0026quot;When I smell the lampblack smell, will feel nauseous involuntarily.\u0026quot;\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSimultaneously, extracorporeal drainage leads to the loss of most potassium and sodium electrolytes and digestive fluid, resulting in a decrease in the digestive function of patients and complications of electrolyte disorders. Therefore, it is recommended that patients with drainage tubes undergo routine biochemical examination every 2~3 days after discharge. The daily diet should include additional electrolytes. For patients undergoing extracorporeal drainage of pancreatic fluid with significant dyspepsia, additional oral administration of compound pancreatic enzyme tablets is required..\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP16: \u0026quot;The doctor told me to eat salty meals, so I can\u0026apos;t eat same meal with my family.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2.2 Theme 2: Physical and mental discomfort\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 23.91% of the patients experienced physical and mental discomfort (22,23.91%), which was primarily manifested by negative psychological experiences, such as anxiety, fear, and family economic pressure, followed by negative physical experiences, including pain, oropharyngeal discomfort, and sleep disorders.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-theme 4: Psychological negative experience\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(1) Anxiety and fear:\u003c/strong\u003e In the interview, when it was mentioned that there was still a long out-of-hospital home catheter, many patients stated that the doctor had informed them before the operation. However, when an actual home catheter was used, the patients and their families exhibited varying degrees of negative psychological coping states of anxiety and fear. For instance,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1 and P12: \u0026quot;Do not know how long the tube will take, can cure the disease or not?\u0026quot;;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2 and P3: \u0026quot;Afraid of this pipe fell, and I don\u0026rsquo;t know how to deal with it.\u0026quot;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3, P4, and P15: \u0026quot;Home is far away from hospital, if there is problem happened how to deal with?.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(2) Family economic pressure:\u003c/strong\u003e During the transition treatment of external drainage tubes placed outside the hospital, patients not only need to bear the cost of surgical treatment and post-care but also require a special person to provide regular support during treatment, daily life, and drainage tube care. The family income source is reduced and requires high medical economic expenditures. This results in significant financial pressure on patients and their families, which not only leads to excessive psychological pressure but also causes the compliance of regular return to the doctor is low, and lead to serious complications due to it.. For instance,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP16: \u0026quot;Every time my son has to ask for a day off to accompany me, the travel fee costs nearly 400 RMB.\u0026quot;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP4: \u0026quot;I don\u0026apos;t make money now; it\u0026apos;s too expensive to get sick.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-theme 5: Physical\u003c/strong\u003e \u003cstrong\u003enegative experience\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(1) Pain and limited activity:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis theme is present in the patient groups of \u0026quot;gallbladder puncture drainage tube\u0026quot; and \u0026quot;pancreatic puncture drainage tube.\u0026quot; The puncture pipe is rigid and cannot completely fit the skin, resulting in shaking of the pipe owing to clothing and pain caused by changes in the body position.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5, P8, and P15: \u0026quot;I feel that the knife edge of the tube hurts\u0026quot;;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \u0026quot;Every time the tape is loosened, the pipe moves up and down with the clothes, which makes the wound uncomfortable and painful strongly\u0026quot;;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5, and P9: \u0026quot;Every time I lie down, the back of the lumbar cavity pierced by this tube hurts\u0026quot;; \u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \u0026quot;I dare not turn to the right side when sleep, I feel that I have poked my liver by the tube.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(2) Oropharyngeal discomfort and\u0026nbsp;\u003c/strong\u003erestricted breathing: This theme is present in the \u0026quot;nasobiliary drainage tube\u0026quot; and \u0026quot;nasopancreatatic drainage tube\u0026quot; patient groups. The tube was inserted retrogradely through the oropharyngeal passage from the nose. Oral breathing has become the primary method for relieving throat irritation, and most patients use body language to reduce pharyngeal activity to avoid pharyngeal stimulation. During the interview, when asked questions that did not appear, the patients answered by shaking heads and waving hands.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \u0026quot;It\u0026rsquo;s very easy to get nausea with this tube, after taking a few deep breaths will be better.\u0026quot;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \u0026quot;There is sore throat greatly during talk because of taugh tube, and generally speaks little.\u0026quot;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eP17: \u0026quot;Wearing this tube it\u0026rsquo;s easy to be nauseous, specially during brushing teeth and coughing.\u0026quot;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(3)\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSleep disorders:\u003c/strong\u003e The sleep quality experienced by patients at night has a significant impact. The majority of patients were concerned about the tubes and feared pulling the tube during sleep, leading to unplanned extubation and resulting in multiple night awakenings to check the pipeline, which leads to sleep disruption and poor sleep quality at night in patients and their family members.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \u0026quot;I always worry about the tube will be pressed or pulled by mistake during sleep, and experience sleep disruption oftenly. So I feel dazed and hypodynamic at daytime.\u0026quot;\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \u0026quot;I am afraid that my husband will accidentally pull out the tube during sleep, so I have been sleeping alone.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Theme 3: Lack of relevant knowledge of disease\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere were 18.48% of patients with a lack of relevant knowledge (17, 18.48%), which mainly manifested as a lack of disease-related knowledge, followed by a lack of nursing pipeline knowledge and weak consciousness of tube nursing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-theme 6: Lack of disease-related knowledge\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEven if doctors provide relevant disease knowledge and health guidance upon discharge, patients have little understanding owing to different educational levels, memory loss or bias over time, and other problems (Wang et al,2019). Furthermore, patients exhibit varying degrees of cognitive differences in disease-related knowledge, resulting in weak compliance. Patients have a significantly increased risk of drainage complications and adverse events, and even drainage fluid develops a white pus coloration accompanied by fever for several days without emergency medical attention.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eP16: \u0026quot;The liquid used to be brown, but now it\u0026apos;s white. Sometimes the color is dark, sometimes light, do not know is normal or not?\u0026quot;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eP8: \u0026quot;Before the flow is more than 200 ML, now there is only 50 ML.\u0026quot; Sometimes the flow is less whole day, is everything okay?\u0026quot;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSome patients do not pay much attention to the progress of the disease and rehabilitation and only care about self-feeling and economic expenditure.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \u0026quot;The biggest concern is when can pull out the tube from my body, and it \u0026nbsp;cost a lot of money for backing visit the doctor every time.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-theme 7: Lack of nursing pipeline skills and weak awareness\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe nurse in charge provided education on pipeline nursing knowledge upon discharge from the hospital, and the hospital established a pipeline nursing clinic to provide pipeline nursing to patients with out-of-hospital pipes. However, because of the patients\u0026apos; insufficient attention and weak awareness of pipeline nursing, they did not return to the hospital in time to reduce economic pressure, which led to the loosening of the fixation of the indwelling end\u0026nbsp;\u003cem\u003ein vitro\u003c/em\u003e and caused complications, such as skin infection around the incision, pipeline blockage, and even slip.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \u0026quot;The tape can not stick; I have no choice but to put a Band-aid on it.\u0026quot;;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \u0026quot;The tube on the nose is too thin, wear for a long time, and accidentally discounted several places; I don\u0026apos;t know whether the tube is still wroking or not?\u0026quot;;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \u0026quot;The skin around this tube itches every time when I sweat, which is really uncomfortable.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 Theme 4: Hope for help\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe patients (27, 29.35%) were positive regarding surgical treatment and rehabilitation, eager to recover as soon as possible, and eager to optimize specific problems existing during the canalization process to obtain assistance from medical staff, for instance, obtaining a suitable drainage device, improving the fixed tape and dressing, and improving the return visits.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-theme 8: Get a suitable drainage device\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWith the increase in drainage time and the recovery of the disease, the drainage fluid will gradually decrease. Hoping to obtain a smaller bag and shorten the length of the drainage bag pipe.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5: \u0026quot;Now there is not much drainage fluid, only 30-40ml a day; I hope to get a small bag; it is too troublesome to carry such a big bag.\u0026quot;;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP14: \u0026quot;Each time this tube has to go around many times, too long, it\u0026rsquo;s too troublesome.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eSub-theme 9: Perfect fixing tape and dressing\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis theme appeared in the patient groups of \u0026quot;gallbladder puncture drainage tube\u0026quot; and \u0026quot;pancreatic puncture drainage tube.\u0026quot; Patients have puncture wounds in the abdomen, which should be kept dry, and the dressing should be kept clean. Adhesive tape mark and body dirt are produced during the tube application, and patients have the strong request of batheing.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eP1: \u0026quot;I can not take a bath, my body is sticky everywhere,it\u0026rsquo;s too uncomfortable\u0026quot;;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eP4: \u0026quot;Is there something waterproof tape and can protect the wound from the water? Let me take a bath comfily.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-theme 10: Improve the status of the subsequent visit\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSome patients need to take 6 to 7 hours by bus for further visits to hospital, the review waiting time is longer, and they are eager to review or replace the pipeline in the local hospital.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \u0026quot;Each round trip cost nearly 400 RMB, and takes too much time,\u003c/em\u003e\u003cem\u003ethe whole day is on the way\u003c/em\u003e\u003cem\u003e.\u0026quot;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \u0026quot;My home is far away from the hospital, when finish the review the disease, and the bus of backing home is finished,. It\u0026rsquo;s very inconvenience.\u0026quot;\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u003cstrong\u003e3.1 Patients of biliary and pancreatic system diseases with tube at out-of-hospital have obvious social negative experiences and need more family care, support, and social acceptance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNegative social experiences refer to the unpleasant things we encounter in our lives and cause us to have negative emotional experiences (Zhou et al, 2024). Negative social experiences are the risk factor for the sub-health of residents and can directly affect health status. The findings of this study indicate that the frequency of negative social experiences was 26, accounting for 28.26% of all catheter experiences, which was the first problem encountered by patients with external ducts in hepatobiliary and pancreatic hospitals. The most significant factors were the strengthening of patient roles and the absence of family roles (64.7%). Such patients often need to carry external drainage tubes outside the hospital due to treatment needs. In this study, the out-of-hospital with tube duration was (37\u0026plusmn;8.9) days. Because of the patient\u0026apos;s nervousness about the medical decision of \u0026quot;out-of-hospital with tube\u0026quot; and worry about recovery from the disease, as well as the lack of knowledge and skills in pipeline nursing, patient was in a state of role strengthening for a long time at home. This leads to the long-term absence of family and social roles, making it difficult to return to society in later stages. Simple aerobic activities and exercises after discharge are also conducive to the early recovery of patients. The Outline of \u0026quot;Healthy China 2030\u0026quot; issued by The State Council \u0026quot;(CPC,2020) clearly points out \u0026nbsp;that it is necessary to adjust and optimize the health service system, meet the health needs of the people, and enhance the sense of medical experience. Therefore, for such patients, medical staff should actively provide extended care services and follow-up management for patients with discharge and management and encourage the transformation of patients\u0026apos; roles to family and society. Second, the average age of participants in this study was 50 \u0026plusmn; 9.4 years. Individuals in this age group generally play the role of mainstays in the family. However, out-of-hospital tubes prevent them from participating in routine work and life, and they may even be compelled to stop working to concentrate on their recovery from illness, which also has different degrees of impact on the work and lifestyle of a family. The patient could no longer participate in physical labor, even simple housework, because of physical discomfort and retention of the drainage tube. They and their families take care of the protection of the drainage tube and make the patient give up activities or work within their capacity. Therefore, in view of the problem of patients\u0026apos; heightened or diminished roles, medical staff should improve communication with patients and their families, assist patients in reestablishing appropriate and positive family and social roles, and perform simple housework activities, such as sweeping the floor, picking dishes within their capacity, prioritizing the family, starting with family empowerment, and encouraging family members to provide patients with more psychological family support. Try to reduce the impact of negative social experiences on patients caused by the role of out-of-hospital care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Patients with out-of-hospital ducts for biliary and pancreatic system diseases have obvious physical and mental discomfort experience, and the body coping style should be appropriately adjusted to reduce complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients with postoperative indenturement ducts for biliary and pancreatic system diseases cannot adapt to the influence of the body, and some physiological functions are limited, consistent with the findings of Zhou et al. (Zhou et al, 2015). Studies have demonstrated that preoperative adaptive nasal blocking and breathing training can enhance the adaptability and endurance of patients (Ren er al,2010). The discomfort experience can be alleviated by adjusting the breathing mode, reducing the stimulation of the restricted part, and altering the body position. Therefore, it is recommended that nurses guide patients on the appropriate use of breathing and swallowing techniques before surgery to prevent coughing during breathing and eating and to reduce oropharyngeal discomfort. Concurrently, medical staff should focus on the psychological assessment of patients in clinical work, monitor psychological and emotional changes during hospitalization, promptly identify and adjust negative concepts, and alleviate patients\u0026apos; negative emotions and concerns. Furthermore, it strengthens communication with family members, pays attention to the psychological experience of patients, promotes positive expression, timely solving patients\u0026apos; demands, and significantly helps patients solve physical and mental discomfort.\u003c/p\u003e\n\u003cp\u003eAccidental extubation, extubation, internal displacement of the tube, and other complications are more traumatic for patients, necessitating another operation, are not conducive to the recovery of patients with tubes, can aggravate their condition, and may even result in death (Cosentino et al,2017). Establish a consultation hotline or patient friend WeChat group, regular telephone follow-up, and patient friend discussion to ensure that patients can receive guidance at any time, provide patients with accurate information support and healthy life guidance, and urge patients to carry out pipeline care and follow-up visits to reduce unplanned extubation and complications and promote patients\u0026apos; recovery.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Patients with biliary and pancreatic system diseases lack knowledge about diseases and drainage tube nursing, so education and science popularization outside hospitals should be strengthened to improve their sense of catheter experience\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKnowledge reserves are the internal motivations for behavior improvement. Some studies have demonstrated that the coping ability of patients receiving home nasal feeding treatment is closely associated with the quantity and quality of acquired knowledge (Serjeant et al,2022). Sufficient knowledge is a prerequisite for a smooth transition to tube feeding and everyday life, which has a synergistic effect with the poor tube experience of patients in this study due to a lack of knowledge and skills about diseases and drainage tube nursing (Strolloet al,2017). Currently, with the continuous expansion and improvement of the health education model, the self-care experiential health education model is a novel educational model for improving the mastery of relevant nursing skills and the self-care ability of patients through situational experience (Zhang et al,2022). Some scholars have applied this model to the health education of patients with closed thoracic drainage tubes, and the results have revealed a significant improvement in the self-care ability and self-efficacy of patients (Zhang et al,2019). There was study (Peng et al,2022) adopted Internet + extended care for patients with T-tubes outside the hospital, and the results demonstrated that it could significantly improve patients\u0026apos; self-care ability and reduce the complication rate.\u003c/p\u003e\n\u003cp\u003eTherefore, nursing staff should take responsibility for disseminating relevant knowledge, strengthening communication with patients and their families, and accurately assessing the extent to which patients possess knowledge of disease\u0026nbsp;and\u0026nbsp;self-management. ①Multi-form and multi-dimensional health education activities can be used to provide a new type of health education oriented by patients and their families, and appropriate self-care experiential or real experience health education with drainage tubes outside the hospital can be carried out to improve patients\u0026apos; knowledge of relevant nursing skills.\u0026nbsp;②Establishing a consultation hotline or WeChat group and regular phone follow-up to ensure patients can receive guidance anytime. Patients should be provided with accurate information, support, and guidance for a healthy life and encouraged to participate in pipeline care and follow-up visits. They should also be assisted in establishing a correct lifestyle with tubes, which will improve their quality of life and treatment effects.\u0026nbsp;③Combined with the development of the Internet and artificial intelligence at this stage, the use of platforms such as WeChat public account, Douyin, and micro video enabled the development of new forms of health education and popular science, created vivid educational content and improved their mastery of disease-related knowledge and nursing skills.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 For patients with the out-of-hospital duct of biliary and pancreatic system diseases, the subsequent hardware configuration of home treatment needs to be further improved\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to Maslow\u0026apos;s hierarchy of needs (Li et al,2019), physiological needs are the most basic needs of the human body, including breathing, food, water, sleep, and physiology. However, this study indicated that the medical decision regarding out-of-hospital tubes has a certain impact on the most basic physiological needs of patients. Several participants mentioned that shower demand during tube wearing could not be guaranteed, and they hoped to have water-resistant fixed devices.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCurrently, our center uses 3M tape (nose tape and I-script tape, Figure 1) for external fixation of patients carrying drainage tubes, guaranteeing a certain fixation effect within 3～5 days. In contrast, the average time of patients with out-of-hospital tubes is (37\u0026plusmn;8.9) days. Patients cannot buy well-matched 3M tape fixations outside the hospital, resulting in poor fixation of out-of-hospital tubes. Due to the high incidence of out-of-hospital catheterization, hospitals can communicate and negotiate with relevant departments, refer to the out-of-hospital management strategy for patients with ostomy, and provide out-of-hospital tube care packages for patients discharged from the hospital with tubes, including anti-reflux screw drainage bags, iodophor disinfection swabs, multiple 3M fixed adhesive tapes, and videos guiding the replacement of drainage bags at home. Medical personnel can also innovate and improve existing devices in this direction and apply them for related patents. Establishing multiple communication channels to ensure patients receive guidance at any time is also possible. In addition to teaching patients and their families about the care of pipes and wounds, provincial hospitals can provide relevant training to medical personnel, including county-level hospitals, township health centers, and community medical service stations. They can also establish corresponding connectivity networks or referral services to ensure patients receive standardized care nearby and reduce complications caused by improper pipe or wound care or timely treatment.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003ePatients with postoperative biliary and pancreatic system diseases with catheters experience varying degrees of stress. Patients encounter numerous challenges during out-of-hospital with drainage tube, including physiological adaptation and disease rehabilitation. This study conducted qualitative interviews on the tube experience of 17 patients with biliary and pancreatic system diseases. The findings indicated that patients exhibited negative social life experiences and physical and mental discomfort during carrying the drainage tube after discharge from hospital. Targeted health education and continuous nursing are necessary to maximize patients\u0026apos; self-care abilities, reduce canal-related complications and anxiety, and improve their quality of life. However, this study has some limitations. The interviewees had regional problems, and the living standards and cultural differences between different regions had an impact on the main feelings of patients. Consequently, the results obtained applied to the entire population of this region.\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFUNDING\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the 2023 Ningxia Natural Science Foundation General Project (2023AAC03622)；2023 Autonomous Region Health System Research Project Youth Science and Technology Cultivation Project (2023-NWKYP-052); Ningxia Medical University General Hospital young backbone medical talent project\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency,commercial or not-for-profit sector.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eCONFLICT OF INTEREST STATEMENT\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflicts of interest or financial disclosures related to this research study. This study was conducted in accordance with ethical guidelines and all necessary approvals were obtained before its commencement.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eDATA AVAILABILITY STATEMENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThe datasets generated during and/or analysed during the current study are available from the first author and corresponding author on reasonable request.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe data are not publicly available due to restrictions [e.g. their containing information that could compromise the privacy of research participants].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBalduino AF, Mantovani MF, Lacerda MR, Marin MJ, Wal ML. Experience of hypertensive patients with self-management of health care. J Adv Nurs. 2016 Nov;72(11):2684-2694. http://doi: 10.1111/jan.13022. Epub 2016 Jun 13. 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Chin J Emer Resus and Disaster Med,,19(03):383-386+413.http://doi:10.3969/j.issn.1673-6966. 2024.03.024.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Biliary pancreatic system diseases, Home with tube, Patient experience with tubes, Qualitative research","lastPublishedDoi":"10.21203/rs.3.rs-5235404/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5235404/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eObjective: This study aimed to understand the experience of patients with external drainage tube out of hospital with biliary and pancreatic system diseases and provide a theoretical basis and reference for formulating nursing intervention measures based on the actual experience of patients with ducts.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: An objective sampling method was used to select patients treated in the Department of Hepatobiliary Surgery and the Pipeline Nursing Outpatient Department of a triple A hospital in Yinchuan City, Ning Xia province, China, and had external drainage tubes in place outside the hospital for more than one month as research objects. Semi-structured interviews were conducted under the guidance of phenomenological research methods, and 17 participants were finally included. This study was reviewed by the Research Ethics Committee of the General Hospital of Ningxia Medical University (Ethics number: KYLL-2022-1341), and all subjects voluntarily participated in this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: Four themes and ten sub-themes were extracted, including negative experiences in social life (reinforcement of patient role and absence of family role, changes in work, life, and lifestyle), physical and mental discomfort experience (negative psychological experience and physical discomfort experience), lack of related knowledge (lack of disease-related knowledge, lack of pipeline nursing skills, and weak consciousness). and hope to get help (obtain the appropriate size of the drainage bag, improve fixed film, and the follow-up method).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusion: The patients’ experience of patients with drainage tube outside of hospital for hepatobiliary and pancreatic system diseases is primarily discomfort. There are some discomfort experiences and a lack of relevant-disease knowledge, and patients are eager to get professional help from the medical staff.\u003c/p\u003e","manuscriptTitle":"Qualitative study of experience of patients with external drainage tube out of hospital with biliary and pancreatic system diseases","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-23 06:26:22","doi":"10.21203/rs.3.rs-5235404/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-10-18T11:32:21+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-10-18T08:24:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-10-11T03:24:29+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Gastroenterology","date":"2024-10-10T00:43:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"227bf3f5-bee0-430f-9911-5e341f7cc286","owner":[],"postedDate":"October 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-10-20T16:01:52+00:00","versionOfRecord":{"articleIdentity":"rs-5235404","link":"https://doi.org/10.1186/s12876-025-04317-9","journal":{"identity":"bmc-gastroenterology","isVorOnly":false,"title":"BMC Gastroenterology"},"publishedOn":"2025-10-14 15:57:05","publishedOnDateReadable":"October 14th, 2025"},"versionCreatedAt":"2024-10-23 06:26:22","video":"","vorDoi":"10.1186/s12876-025-04317-9","vorDoiUrl":"https://doi.org/10.1186/s12876-025-04317-9","workflowStages":[]},"version":"v1","identity":"rs-5235404","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5235404","identity":"rs-5235404","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}