基于理论域框架的癌症患者自我管理行为影响因素分析  

Influencing factors of self-management behavior in cancer patients based on a theoretical domain framework

作　　者：鲜雪梅[1] 陈依琳[1] 乔世娜[1] 邵静 汪曼君 孙丽秋 叶志弘[1,2] XIAN Xuemei;CHEN Yilin;QIAO Shina;SHAO Jing;WANG Manjun;SUN Liqiu;YE Zhihong(Nursing Department,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China;Institute of Nursing Research,Zhejiang University School of Medicine,Hangzhou 310058,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院护理部,浙江杭州310016 [2]浙江大学医学院护理学研究所,浙江杭州310058

出　　处：《浙江大学学报（医学版）》2023年第5期605-615,共11页Journal of Zhejiang University(Medical Sciences)

基　　金：浙江省自然科学基金(LY23G030008);浙江省软科学研究计划(2021C35073)。

摘　　要：目的:基于理论域框架分析影响癌症患者自我管理行为的影响因素,为精准干预癌症患者自我管理行为提供依据。方法:检索万方数据、中国知网、维普网、中国生物医学文献数据库(SinoMed)、PubMed、Embase、CINAHL、Web of Science核心合集、Cochrane library、Medline等数据库从建库到2022年6月关于癌症患者自我管理行为影响因素的中英文文献。两位研究者独立识别、提取数据,收集研究特征和方法。采用Nvivo12软件以理论域框架理论域为一级节点对影响因素进行编码,然后使用主题分析提炼二级节点,最后对具体影响因素进行汇总和分析。结果:共纳入34篇文献,共有194个编码点被编码到13个理论域,并归纳出31个二级节点;涉及环境和资源、社会/职业角色和认同、结果信念三个理论域的相关节点最多;知识、年龄、自我效能、疾病分期、社会支持、性别、经济状况、身体状况是对自我管理影响较多的单因素。结论:癌症患者自我管理的影响因素涉及理论域框架的绝大多数理论域,并且具有交叉性、多源性和复杂性。Objective:To explore the factors that influence self-management behavior in cancer patients based on the theoretical domain framework.Methods:Studies in Chinese and English about factors influencing self-management behavior in cancer patients were searched from Wanfang database,CNKI,VIP,SinoMed,PubMed,Embase,CINAHL,Web of Science Core Collection,Cochrane library and Medline from inception to June 2022.Two investigators independently identified,extracted data,and collected characteristics and methodology of the studies.Factors were analyzed with Nvivo12,and the theoretical domain framework was mapped to the theoretical domain.Then the secondary node was generalized by theme analysis.Finally,the specific influencing factors were summarized and analyzed.Results:Thirty-four studies were included for analysis.A total of 194 factors were mapped to 13 theoretical domains,and 31 secondary nodes were summarized.Theoretical domains environmental context and resources,social/professional role and identity,and beliefs about consequences were the most common factors.Knowledge,age,self-efficacy,disease stage,social support,gender,economic status and physical status were the most influential factors for self-management in cancer patients.Conclusion:The influencing factors of self-management of cancer patients involve most of the theoretical domains,are intersectional,multi-source and complex.

关 键 词：癌症 存活者 健康管理 自我管理 行为 理论域 

分 类 号：R730.1[医药卫生—肿瘤]