晚期癌症患者家属安宁疗护决策体验的质性研究  

Qualitative study on palliative care decision-making experience of family members of patients with advanced cancer

作　　者：逄天宇 袁玲 武丽桂[3] 周玉洁[3] 王丹若 周智 颜恺然 孙露露 PANG Tianyu;YUAN Ling;WU Ligui;ZHOU Yujie;WANG Danruo;ZHOU Zhi;YAN Kairan;SUN Lulu

机构地区：[1]南京中医药大学护理学院,南京市210023 [2]南京中医药大学鼓楼临床医学院肿瘤科 [3]南京大学医学院附属鼓楼医院肿瘤科 [4]南京医科大学附属明基医院缓和医学科

出　　处：《中华护理杂志》2023年第13期1559-1564,共6页Chinese Journal of Nursing

基　　金：南京鼓楼医院护理科研一般项目(2023-A705)。

摘　　要：目的探索晚期癌症患者家属在参与安宁疗护决策时的体验,为制订决策辅助策略提供依据。方法采用目的抽样法,于2022年12月—2023年1月对南京市2所三级甲等医院安宁疗护病房收治的12例晚期癌症患者的家属进行半结构式访谈,运用Colaizzi 7步分析法对访谈资料进行分析、归纳并提炼主题。结果共提炼出3个主题及9个亚主题:①复杂的决策感受,包括无助感、犹豫不决、内心坚定;②缺乏有效的决策支持,包括安宁疗护相关信息的可及性低、医患间信息不对称、医护人员的安宁疗护宣传意识薄弱;③多重决策动机,包括满足患者的舒适需求、缓解家庭的照顾负担、减轻经济压力。结论晚期癌症患者家属在安宁疗护决策过程中的体验复杂,医护人员应不断提高安宁疗护实践能力,有针对性地为晚期癌症患者家属提供决策支持,改善其决策体验,促进安宁疗护的实施。Objective To explore the real experience of family members of advanced cancer patients in participating in palliative care decision-making,and to provide evidence for making decision-making assistant strategies.Methods Using the method of objective sampling,the semi-structured interview was conducted with family members of patients with advanced cancer from December 2022 to January 2023.Colaizzi 7-step analysis method was used to analyze,summarize,integrate and refine the data.Results A total of 3 themes and 9 sub-themes were extracted.Theme 1:complex decision-making experience(helplessness,hesitation,determination).Theme 2:lack of decision-making information and communication(low accessibility of palliative care information,information asymmetry between doctors and patients,weak awareness of promoting palliative care of medical staff).Theme 3:multiple decision motivation(meeting patient comfort needs,alleviating family care burden,reducing economic burden).Conclusion The decision-making of palliative care for the families of advanced cancer patients is a complex process.Medical staff should continuously improve their palliative care capabilities,provide targeted decision-making support for the families,optimize the decision-making experience and promote the implementation of palliative care.

关 键 词：癌症 家属 安宁疗护 决策体验 质性研究 

分 类 号：R473.73[医药卫生—护理学]