原发性肝癌患者诊断知情过程中真实心理体验的质性研究  

Qualitative Research on True Psychological Experience of Disease Notification of Primary Liver Cancer Patients

作　　者：孙丽萍[1] 李丽[2] 叶志霞[1] 

机构地区：[1]第二军医大学东方肝胆外科医院护理部,上海200438 [2]第二军医大学东方肝胆外科医院监护室

出　　处：《解放军护理杂志》2015年第3期1-5,共5页Nursing Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金青年基金项目(81101830);第二军医大学优秀硕士研究生苗子培育基金

摘　　要：目的了解原发性肝癌(primary liver cancer,PLC)患者对诊断知情的态度以及其诊断知情过程中的真实心理体验,以期为肝癌患者及其家属提供人性化的护理。方法 2013年10-12月,采用目的性抽样法选择在第二军医大学东方肝胆外科医院住院治疗的8名PLC患者为研究对象,采用现象学研究方法,对其进行半结构式访谈,现场录音,整理、分析资料,提炼主题。结果 PLC患者对诊断知情的态度可归纳为5个主题,即长期隐瞒疾病诊断不可行;告知疾病诊断有利于患者配合治疗;告知疾病诊断时应该因人而异;告知疾病诊断时医生应与患者交流,给予希望;告知疾病诊断内容不够全面。PLC患者诊断知情过程中的负性情绪包括紧张、焦虑、抑郁、情绪不稳及回避。结论医护人员在告知PLC患者疾病诊断时,应该因人而异,给予患者治疗的希望,同时护理人员应注意PLC患者在疾病诊断知情过程中存在的负性情绪,为其提供人性化的关怀。Objective To understand the true psychological experience of disease notification of primary liver cancer patients,and to provide the humanized nursing intervention to PLC patients and family members.Methods By using phenomenological research methods,8 PLC patients had semi-structured interview and the record was organized and analyzed accordingly with theme refined.Results Five themes about the PLC patients＇ attitude toward disease disclosure were summarized as follows.hiding diagnosis is not possible for a long time; truth telling is good for therapy; different patients have different styles to disclose; give the hope of therapy while the doctors communicate the disease with patients; satisfy patients＇ demand for knowledge and information. Four themes about negative emotion when patients know their diagnosis were summarized as follows, tension and anxiety, depression, emotional instability and avoiding.Conclusion Different patients required different styles to be told about the real disease situation, at the same time we should give hope of therapy to patients, and pay attention to the patient＇s negative emotion, which calls for humane concern based on the needs of patients.

关 键 词：原发性肝癌 质性研究 真相告知 心理 

分 类 号：R735.7[医药卫生—肿瘤] R395.1[医药卫生—临床医学]