肺癌患者术后居家症状报告结局及管理需求的混合研究  

Patient reported outcomes of symptoms at home and symptom management needs after lung cancer surgery:a mixed-method study

作　　者：刘云访 张桃 高兴莲 吴晓 王思桦 吴创炎 郑佳莉 Liu Yunfang;Zhang Tao;Gao Xinglian;Wu Xiao;Wang Sihua;Wu Chuangyan;Zheng Jiali(Department of Thoracic Surgery,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院胸外科,湖北武汉430022 [2]华中科技大学同济医学院附属协和医院护理部,湖北武汉430022

出　　处：《护理学杂志》2024年第8期10-14,共5页Journal of Nursing Science

摘　　要：目的了解肺癌患者术后居家症状报告结局及管理需求,为医护人员开展延续干预措施提供参考。方法采用早期肺癌术后患者报告结局量表对384例早期肺癌术后居家患者进行调查;基于目的抽样法选取其中15例患者进行症状管理需求的半结构式访谈。结果早期肺癌术后患者报告结局量表得分由高到低分别是生理领域(2.59±0.71)分、治疗领域(2.54±0.46)分、社会领域(2.27±0.65)分、心理领域(1.71±0.84)分。13个维度得分处于前3位的是独立性(4.00±1.18)分、胸部症状(3.02±0.52)分和社会适应(2.91±1.12)分。质性访谈提炼出4个主题,包括生理需求:居家症状多样化,症状管理服务需求强烈;心理需求:焦虑和担心,希望得到及时关怀和沟通;社会需求:症状不适时希望得到家人的理解和照护;治疗需求:需要专业医护人员的延续照护和康复指导。结论肺癌患者术后居家症状多样化且管理需求强烈,可通过建设信息智慧平台等方式为患者提供症状管理支持。Objective To investigate patient reported outcomes of symptoms at home and management needs after lung cancer surgery,and to provide a reference for medical staff to carry out continuous intervention measures.Methods A total of 384 home-residing patients in the early period after surgery for early-stage lung cancer were surveyed by the Patient Reported Outcomes Scale After Early-stage Lung Cancer Surgery.Then semi-structured interviews on symptom management needs were conducted among 15 patients based on purposive sampling method.Results The scores of the Patient Reported Outcomes Scale After Early-stage Lung Cancer Surgery were as follows in descending order:physiological field(2.59±0.71),treatment field(2.54±0.46),social field(2.27±0.65),and psychological field(1.71±0.84).The top 3 scores in the 13 dimensions were independence(4.00±1.18),chest symptoms(3.02±0.52),and social adaptation(2.91±1.12).Four themes were identified in the qualitative research:physiological needs(diversified symptoms occurring at home,hoping to receive symptom management services);psychological needs(being anxious and worried,hoping for timely care and communication);social needs(hoping to receive understanding and care from family when feeling uncomfortable);treatment needs(continuous care and rehabilitation guidance from professional medical staff).Conclusion Postoperative symptoms of lung cancer patients at home were diverse,and they had a strong demand for symptom management.Such measures as building an information intelligence platform might provide symptom management support for patients.

关 键 词：肺癌 居家 报告结局 症状管理 需求 混合方法研究 延续护理 康复指导 

分 类 号：R473.6[医药卫生—护理学]