晚期肺癌患者参与及执行治疗决策的心理体验及支持性需求的现象学研究  

A qualitative study of the psychological experience and supportive needs of patients with advanced lung cancer participating in and implementing treatment decisions

作　　者：张朝晖[1] 谢凤兰[2] 陈爱萍[1] 白丽红[1] 郭禹标[1] Zhang Zhaohui;Xie Fenglan;Chen Aiping;Bai Lihong;Guo Yubiao(Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital,Sun Yat-sen University,Guangdong Guangzhou,510080;Nursing department,The First Affiliated Hospital,Sun Yat-sen University,Guangdong Guangzhou,510080)

机构地区：[1]中山大学附属第一医院呼吸与危重症医学科,广东广州510080 [2]中山大学附属第一医院护理部,广东广州510080

出　　处：《现代临床护理》2020年第7期30-36,共7页Modern Clinical Nursing

基　　金：广东省自然科学基金项目,项目编号为18zxxt17;广州市科技基金项目,项目编号为201707010185。

摘　　要：目的深入探讨晚期肺癌患者参与及执行治疗决策的真实体验,了解患者在治疗过程的支持性需求,旨在为构建专科护士主导的肺癌患者参与及执行治疗决策支持方案提供参考。方法采用质性研究中的现象学研究法,对17例晚期肺癌患者进行半结构式访谈.以Colaizzi 7步法对访谈内容进行整理分析。结果共得出3个主题:①决策参与程度低,治疗信息缺乏,主要表现在治疗方案的选择参与度低、对保守治疗方案欠了解、缺乏辅助治疗的专业信息;②躯体不适及心理痛苦,主要表现为经济负担重、多样化的躯体不适、不同程度的心理痛苦;③治疗过程支持性需求,主要表现在希望能得到简化就医流程、提供专业营养指导、疏导负性情绪、协助回归社会生活等方面的支持。结论晚期肺癌患者参与治疗决策的程度低,需要医护人员提供专业的决策信息;在执行决策的过程中困扰多,针对性的症状群管理非常重要;同时,患者在保守治疗的过程中,尊严的需求凸显,迫切希望医护人员简化就医流程,减轻就医负担;提供专业的营养指导和及时的心理辅导,在家属的协助下回归社会生活。Objective To explore the real experience of patients with advanced lung cancer participating in and implementing treatment decisions,and to understand the supportive needs of patients during treatment.Methods A semi-structured interview was conducted in 17 patients with advanced lung cancer by means of phenomenological research.Colaizzi 7 method was used to analyze the interview contents.Results There are three main themes:(1)low participation in decision-making and lack of treatment information:low participation in the choice of treatment plan,lack of understanding of conservative treatment plan,lack of professional information of adjuvant treatment;(2)more trouble in the implementation of treatment plan:the main manifestation is heavy economic burden,diversified physical discomfort,different degrees of psychological pain.Treatment process support needs:mainly hope to be able to simplify the medical process,provide professional nutrition guidance,negative emotions,help return to the lives of ordinary people and other aspects of support.Conclusions Patients with advanced lung cancer have a low degree of participation in treatment decision-making and need medical staff to provide professional decision-making information.At the same time,patients in the process of conservative treatment,the need for dignity highlights,eager to medical staff to simplify the process of medical treatment,reduce the burden of medical treatment;provide professional nutrition guidance and timely psychological counseling,with the assistance of family members to return to normal life.

关 键 词：肺肿瘤 治疗决策 心理体验 支持性需求 质性研究 

分 类 号：R473.73[医药卫生—护理学]