输注多柔比星骨肿瘤患者预期性胃肠道反应的质性研究  

Anticipatory Gastrointestinal Symptoms in Patients with Bone Tumors Receiving Parenteral Adriamycin:A Qualitative Study

作　　者：郭真真[1] 马燕兰[1] 郑晓缺[1] 

机构地区：[1]解放军总医院护理部,北京100853

出　　处：《解放军护理杂志》2012年第13期16-19,共4页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨多柔比星治疗患者预期性胃肠道反应的发生与个体认知能力、心理应激状况及认知行为策略的关系,为制定有效的护理干预措施奠定基础。方法本研究以质性研究中的Colaizzi现象学方法为指导,采用面对面、深度访谈的方式,了解恶性骨肿瘤患者在疾病诊疗过程中的情绪变化及药物所致不良反应的应对方式等,采取现象学资料7步分析法对谈话内容进行归类总结。结果预期性胃肠道反应患者化疗后胃肠道反应比较严重;且在疾病诊疗过程中,患者心理负担较重,因缺乏癌症及化疗相关知识,存在焦虑、抑郁等负性情绪;化疗前对不良反应具有较高预期;不同患者的应对方式因其认知能力和心理应激状况而不同。结论条件反射在预期性胃肠道反应形成过程中具有重要作用,预期性胃肠道反应的发生与输注多柔比星后的高胃肠道反应的发生率及患者对多柔比星的厌恶和化疗的恐惧密切相关。Objective To study the relationship between incidence of anticipatory gastrointestinal symptoms in patients with bone tumors receiving parenteral adriamycin and individual cognitive abilities, psy- chological status and cognitive-behavioral strategies, so as to provide the basis for effective nursing intervention. Methods Following the guidance of colaizzis phenomenological method in qualitative research and using in-depth interviews, the coping styles of emotional changes in the diagnosis and treatment of disease and drug response due to adverse reactions were studied. The conversation results were classified by using seven-step analysis of Colaizzi＇s phenomenological data. Results Patients with anticipatory gastrointestinal symptoms experienced severe postchemotherapy adverse gastrointestinal reactions. In the diagnosis and treatment of disease, Patients were observed with severe psychological burden due to lack of knowledge of cancer and chemotherapy and there were anxiety, depression and other negative emotions. High expecta- tions of adverse reactions were determined before chemotherapy. The coping styles varied with their cogni- tive ability and psychological stress. Conclusion Cassic conditioning mechanisms plays an important role in the development of anticipatory gastrointestinal symptoms. There are close relationships between anticipatory gastrointestinal symptoms and severe post-chemotherapy adverse gastrointestinal reactions,aversion to adriamycin.

关 键 词：多柔比星 骨肿瘤 预期性胃肠道反应 质性研究 

分 类 号：R197.323[医药卫生—卫生事业管理]