肝癌行免疫治疗患者延续护理需求的质性研究  

Qualitative research on continuing care needs of patients with liver cancer undergoing immunotherapy

作　　者：孙青 李国宏[1] 金晓灵[1] 李昆鹏[1] 陈进霞[1] 杨霞[2] Sun Qing;Li Guohong;Jin Xiaoling;Li Kunpeng;Chen Jinxia;Yang Xia(Department of Nursing,Zhongda Hospital Affiliated to Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院护理部,江苏南京210009 [2]东南大学附属中大医院手术室,江苏南京210009

出　　处：《护理学杂志》2024年第16期34-37,46,共5页Journal of Nursing Science

基　　金：东南大学附属中大医院护理科研基金项目(KJZC-HL-202207)。

摘　　要：目的了解肝癌行免疫治疗患者延续护理需求,为临床制定延续照护策略提供参考。方法采用描述性质性研究,通过目的抽样法选取17例接受免疫治疗的肝癌患者进行半结构式深度访谈,并应用内容分析法进行资料分析和主题提炼。结果共提炼出4个主题和14个亚主题:缓解躯体不适需求(消化系统不适症状、皮肤不适症状、全身性不适症状和神经系统不适症状),健康生活方式指导需求(饮食指导需求、康复锻炼指导需求、睡眠促进需求和免疫疗法相关信息支持需求),社会心理支持需求(家庭支持需求、社会参与需求、情绪自我调适需求),社会资源支持需求(降低经济负担需求、社区卫生资源支持需求、多渠道延续照护需求)。结论肝癌免疫治疗患者延续护理服务需求较高,且需求呈现个体化及多样性特征。医护人员需重视患者症状管理,加强健康生活方式宣教,关注患者负性心理和社会参与度,结合患者延续护理需求构建并实施供需匹配的延续照护方案。Objective To understand the continuing care needs of patients with liver cancer undergoing immunotherapy and to provide a reference for the formulation of continuing care strategies in clinical practice.Methods Using the purposive sampling method,17 liver cancer patients receiving immunotherapy were selected for semi-structured in-depth interviews,and content analytical method was applied for data analysis and theme extraction.Results A total of 4 themes and 14 sub-themes were extracted:the need to alleviate physical discomfort(digestive system discomfort symptoms,skin discomfort symptoms,systemic discomfort symptoms,and neurological discomfort symptoms);the need for guidance on a healthy lifestyle(diet guidance needs,rehabilitation exercise guidance needs,sleep promotion needs,and information support needs related to immunotherapy);psychosocial support needs(family support needs,social participation needs,and emotional self-regulation needs);social environmental support needs(the need to reduce economic burden,the need for support from community health resources,and the need for multi-channel continuing care).Conclusion Patients with liver cancer undergoing immunotherapy have a high demand for continuing care services,and the needs are individualized and diverse.Medical staff need to pay attention to symptom management of patients,strengthen health lifestyle education,pay attention to patients′negative thinking and social participation,and construct and implement a continuing care plan that matches supply and demand based on the continuing care needs of patients.

关 键 词：肝癌 免疫治疗 躯体不适 生活方式 延续护理 护理需求 心理支持 质性研究 

分 类 号：R473.73[医药卫生—护理学]