颅内肿瘤患者行伽玛刀治疗体验质性研究  

Experience of undergoing gamma knife radiosurgery in patients with intracranial tumor:a qualitative research

作　　者：钱大棣 周宏珍[4] 王洪筱[1] 邓水娟 龙浩[1] QIAN Da-di;ZHOU Hong-zhen;WANG Hong-xiao;DENG Shui-juan;LONG Hao(Dept.of Neurosurgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Dept.of Rehabilitation Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;School of Nursing,Southern Medical University,Guangzhou 510515,China;Baiyun Branch,Nanfang Hospital,Southern Medical University,Guangzhou 510410,China)

机构地区：[1]南方医科大学南方医院神经外科,广东广州510515 [2]南方医科大学南方医院康复科,广东广州510515 [3]南方医科大学护理学院,广东广州510515 [4]南方医科大学南方医院白云分院,广东广州510410

出　　处：《护理学报》2024年第11期6-11,共6页Journal of Nursing（China）

基　　金：广东省自然科学基金项目(2023A1515012382)。

摘　　要：目的了解颅内肿瘤患者行伽玛刀治疗的过程体验,为制定护理干预策略提供参考依据。方法采用目的抽样法,选取2023年6-9月入住某神经外科伽玛刀中心的12例患颅内肿瘤行伽玛刀治疗的患者,进行半结构式访谈,采用Colaizzi 7步分析法分析资料并提炼主题。结果归纳出以下5个主题。(1)确诊时的感受与应对:复杂情绪反应;积极调动应对资源。(2)对伽玛刀治疗的态度:犹豫不决;服从医生;欣然接受。(3)治疗中的感受:疼痛;病耻感;幽闭恐惧;轻松舒适;温暖有爱。(4)治疗中的内外部应对:内部应对为忍耐与回避、正念冥想、分散注意力、躯体放松;外部应对为家庭、朋友支持、医务人员支持、社会支持。(5)治疗后的感受:如释重负;顺其自然;期待重生。结论在伽玛刀治疗的不同阶段,颅内肿瘤患者情绪及其应对呈现动态变化的特点;患者对伽玛刀治疗的认知水平与接受程度逐渐提高;患者能调动内外部支持系统,积极应对治疗中的不适感受和负性情绪。提示应了解患者不同阶段的情绪反应和认知特点,帮助积极应对,以便降低患者对疾病及治疗的恐惧、焦虑、疼痛等不良反应,顺利完成伽玛刀的治疗。Objective To understand the experience of undergoing gamma knife radiosurgery in patients with intracranial tumor,and to provide reference for nursing intervention.Methods The purpose sampling method was adopted,12 patients with intracranial tumors treated with gamma knife radiosurgery were interviewed from June 2023 to September 2023 by semi-structured interviews,and the data were analyzed by Colaizzi’s seven-step method.Results After the analysis of the interview data,6 themes were extracted:(1)Feelings when diagnosed:shock and confusion,fear,and anxiety;(2)Response after diagnosis:Seeking help and medical treatment proactively;(3)Attitude towards gamma knife treatment:hesitancy,compliance with the doctor,and acceptance;(4)Feelings during treatment:pain,sense of stigma,claustrophobia,comfort and relaxation,andawarmth and care;(5)Internal and external coping style during treatment:internal coping(endurance and avoidance,mindfulness meditation,distraction,and physical relaxation);external coping(support from family,friends,and medical staff,and social support);(6)Feeling after treatment:relief,accept what happened,and hope for new life.Conclusion During different stages of gamma knife radiosurgery,patients with intracranial tumors exhibit dynamic changes in emotions,characterized by a negative-positive-negative-positive curve.Their level of understanding and acceptance of the treatment gradually improves.Patients are able to mobilize both internal and external support systems to actively cope with discomfort and negative emotions during treatment.It is important to understand the emotional and cognitive characteristics of patients at different stages and provide support to help them cope positively,thereby reducing their fear,anxiety,pain,and other adverse reactions to the disease and treatment,and facilitating the successful completion of the treatment.

关 键 词：颅内肿瘤 伽玛刀治疗 治疗体验 质性研究 

分 类 号：R473.73[医药卫生—护理学]