消化道肿瘤患者居家口服化疗药物不良反应自我管理体验的质性研究  

A qualitative study on self-management experience of adverse reactions of oral chemotherapy drugs at home in patients with gastrointestinal tumors

作　　者：李晓莉 孟爱凤[1,2] 徐桂华[3] 智晓旭[1,2] 张柳柳 邾萍[1,2] Li Xiaoli;Meng Aifeng;Xu Guihua;Zhi Xiaoxu;Zhang Liuliu;Zhu Ping(Nursing Department,Jiangsu Cancer Hospital&Jiangsu Institute of Cancer Research&The Affiliated Cancer Hospital of Nanjing Medical University,Nanjing 210009,China;Cancer Nursing Research Sub-Center,Nursing Research Center,Nanjing Medical University,Nanjing 210009,China;School of Nursing,Nanjing University of Chinese Medicine,Nanjing 210023,China)

机构地区：[1]江苏省肿瘤医院,江苏省肿瘤防治研究所,南京医科大学附属肿瘤医院护理部,南京210009 [2]南京医科大学护理研究中心肿瘤护理研究分中心,南京210009 [3]南京中医药大学护理学院,南京210023

出　　处：《中华现代护理杂志》2022年第24期3244-3248,共5页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金青年项目(71904090);江苏省重点研发计划(社会发展)项目(BE2019757);2021年江苏省研究生科研与实践创新计划(SJCX21_0666);南京医科大学护理研究中心肿瘤护理研究分中心开放课题(NYZLKF-1-202103)。

摘　　要：目的探讨居家口服化疗患者药物不良反应自我管理的内心体验, 为医务人员更好地对患者实施居家监管提供依据。方法本研究为质性研究, 采用目的抽样方法选取2021年4—5月南京市某三级甲等医院肿瘤内科收治的需要居家口服化疗的12例消化道肿瘤患者进行半结构式深度访谈, 采用Colaizzi 7步分析法对访谈资料进行分析、总结、归纳。结果居家口服化疗患者药物不良反应自我管理的内心体验共提炼出3个主题、7个副主题。主题1:居家口服化疗患者药物不良反应自我管理的感知。面对不良反应产生焦虑和恐惧;寻求与医护沟通时存在矛盾心理。主题2:居家口服化疗药物患者药物不良反应自我管理的态度和行为。对骨髓抑制不良反应的主动复查重视不够;药物不良反应的识别能力欠缺。主题3:居家口服化疗患者药物不良反应自我管理的动力和需求。家属的悉心照顾给予强大支持;移动通讯方式的便利缓解了患者困扰;在口服化疗药物不良反应的信息知识方面存在需求。结论医护人员需加强居家口服化疗消化道肿瘤患者的药物知识宣教、心理护理, 并建设移动信息化平台, 提高患者的自我管理能力。Objective To explore the inner experience of self-management of adverse drug reactions in patients with oral chemotherapy at home,so as to provide a basis for medical staff to better implement home supervision of patients.Methods This study was a qualitative study.The purposive sampling method was used to select 12 patients with gastrointestinal tumors who were admitted to Department of Oncology of a ClassⅢGrade A hospital in Nanjing from April to May 2021 and were required to take oral chemotherapy drugs at home for semi-structured in-depth interviews.Colaizzi's 7-step analysis method was used to analyze and summarize the interview data.Results A total of 3 themes and 7 sub-themes were extracted from the inner experience of self-management of adverse drug reactions in patients with oral chemotherapy at home.Theme one was the perception of self-management of adverse drug reactions in patients undergoing oral chemotherapy at home.This included anxiety and fear in the face of adverse reactions and ambivalence in seeking to communicate with medical staff.The topic two was the attitude and behavior of self-management of adverse drug reactions in patients with home-based oral chemotherapy drugs.This included insufficient attention to active review of adverse effects of myelosuppression and a lack of ability to identify adverse drug reactions.The topic three was the motivation and needs of self-management of adverse drug reactions in patients with home-based oral chemotherapy.The family's careful care provided strong support,the convenience of mobile communication relieved the patient's troubles and there was a need for information and knowledge of the adverse reactions of oral chemotherapy drugs.Conclusions Medical staff need to strengthen drug knowledge education and psychological care for gastrointestinal tumor patients taking oral chemotherapy drugs at home and build a mobile information platform to improve their self-management capabilities.

关 键 词：消化系统肿瘤 口服化疗药物 不良反应 质性研究 

分 类 号：R473.73[医药卫生—护理学]