肿瘤化疗合并焦虑抑郁患者心理干预阻碍因素的质性研究  

Quantitative research on barriers of acceptance of psychological interventions in cancer patients with chemotherapy and depression or anxiety

作　　者：陈阳阳[1] 杨笑梅[1] 褚倩[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤科,武汉430030

出　　处：《中华现代护理杂志》2016年第29期4226-4229,共4页Chinese Journal of Modern Nursing

基　　金：华中科技大学同济医学院附属同济医院基金项目（20048049）

摘　　要：目的探讨住院化疗且存在焦虑抑郁肿瘤患者接受心理干预的阻碍因素，为心理干预服务的实施方式提供参考。方法采用质性研究中的现象学方法，使用半结构式开放性问题对15名正在肿瘤内科病房进行化疗且存在焦虑抑郁情绪的肿瘤患者进行深入访谈。使用内容分析法分析访谈资料。结果住院化疗的焦虑抑郁肿瘤患者接受心理干预主要障碍来自两方面，一是来自患者自身的障碍，包括躯体症状困扰、对心理健康知识了解不足、病耻感、回避疾病和经济压力，二是来自医疗体系的障碍，包括心理服务资源稀缺和心理服务与肿瘤诊疗服务未能有效整合。结论应积极控制患者化疗相关、疼痛等躯体症状。为患者提供适当心理教育，鼓励患者寻找适合自己的干预方式，有效识别患者病耻感，为患者选择合适的心理介入方式和时机．将心理问题诊疗服务整合到肿瘤临床中，完善肿瘤患者心理问题的诊疗流程。Objective To explore the barriers of acceptance of psychological intervention in cancer patients with chemotherapy and depression or anxiety, and provide references for The implement method of psychological intervention services.Methods Phenomenological methods in the qualitative research and semi- structured open questions were used to investigate 15 cancer patients with depression or anxiety who were receiving the chemotherapy in oncology ward. Material analysis was used to analyze the interview data. Results Barriers of acceptance of psychological intervention in cancer patients with chemotherapy and depression or anxiety were mainly from two aspects, one was from patients＇ themselves which includes somatic symptom, lack of acknowledgement in mental health, stigma, disease-avoiding and economic pressure, and the other one was from medical system which includes lack of mental health resource and the separation of psycho- intervention and cancer treatment. Conclusions Nursing staff should actively control the symptoms and pain related to chemotherapy; provide appropriate psychoeducation and encourage patients to get the best way of intervention; recognize the stigma and choose appropriate method and timing for patients ; combine the mental health management into clinical treatment of tumor, and optimize the diagnosis and treatment process of psychological distress in cancer patients.

关 键 词：肿瘤患者 心理干预 阻碍因素 质性研究 

分 类 号：R473.73[医药卫生—护理学]