基于深度访谈法的乳腺癌幸存者失眠认知及针灸治疗偏好调查研究  

Investigation on cognition for insomnia and preference for acupuncture in breast cancer survivors:a in-depth interview study

作　　者：巴东升 郭扬 陈波 翟静波 吕笑颜 王斌[6] 陈翱翔 傅丽媛 陈泽林 郭义 BA Dongsheng;GUO Yang;CHEN Bo;ZHAI Jingbo;LV Xiaoyan;WANG Bin;CHEN Aoxiang;FU Liyuan;CHEN Zelin;GUO Yi(School of Acupuncture-Moxibustion and Tuina,Tianjin University of TCM,Tianjin 301617,China;Department of Acupuncture and Moxibustion,First Teaching Hospital of Tianjin University of TCM;Department of Acupuncture and Moxibustion for Encephalopathy,Tianjin Binhai New Area Hospital of TCM,Tianjin 300451;National Clinical Research Center for Chinese Medicine Acupuncture,Tianjin 301617;School of Public Health and Health Sciences,Tianjin University of TCM,Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer;Department of Integrated Chinese and Western Medicine,Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer;Department of Breast Surgery,Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer)

机构地区：[1]天津中医药大学针灸推拿学院,天津301617 [2]天津中医药大学第一附属医院针灸部 [3]天津市滨海新区中医医院针灸脑病科,天津300451 [4]国家中医针灸临床医学研究中心,天津301617 [5]天津中医药大学公共卫生与健康科学学院,天津医科大学肿瘤医院/国家肿瘤临床医学研究中心 [6]天津中医药大学公共卫生与健康科学学院中西医结合科 [7]天津中医药大学公共卫生与健康科学学院乳腺外科

出　　处：《中国针灸》2024年第9期1023-1028,共6页Chinese Acupuncture & Moxibustion

基　　金：现代中医药海河实验室科技项目;国家中医药管理局中医药标准化项目:GZT-FJS-2020-202;世界针灸学会联合会2023年度针灸国际标准项目:WFASRP2023。

摘　　要：目的:基于深度访谈法了解乳腺癌幸存者对失眠的认知和针灸治疗偏好。方法:选取30例有失眠症状的乳腺癌幸存者进行深度访谈,访谈内容包含睡眠期望、失眠的认知(失眠引起的不适、失眠的可能诱发因素)和针灸治疗偏好(曾用过的治疗方法、未选择针灸治疗的原因和针灸治疗的倾向性)3个方面,基于Colaizzi内容分析法对数据进行分析。结果:大部分有失眠症状的乳腺癌幸存者的睡眠期望为能够维持白天的正常功能状态;失眠症状常会导致患者疲劳,诱发失眠的因素主要为内分泌治疗、预期性焦虑和不良睡眠卫生习惯;所有患者均采用过药物治疗,非药物疗法的应用比例较低,针灸多因“不了解”和“怕痛”而未被选择,对于针灸治疗偏好,患者更倾向于痛感轻微、刺激较弱的针灸疗法,每周2~3次治疗更容易被接受。结论:乳腺癌幸存者对睡眠有期望,睡眠困扰时均采用过药物治疗,部分不愿接受针灸治疗的患者,多因不知道针灸可以治疗以及惧怕强烈的针感,期望有更舒适化的针灸。Objective To understand the cognition for insomnia and preference for acupuncture in breast cancer survivors based on the in-depth interview.Methods Thirty breast cancer survivors with insomnia symptoms were collected for in-depth interview.The interview questions included three aspects,i.e.sleep expectation,cognition for insomnia(discomfort caused by insomnia,and underlying inducing factors of insomnia)and the preference for acupuncture(treatment methods used in the past,the reasons for not choosing acupuncture,and the tendency of acupuncture treatment).Using Colaizzi content analysis method,the data was analyzed.Results Regarding sleep expectation,most breast cancer survivors with insomnia symptoms were able to maintain normal activity in daytime.Insomnia symptoms often led to fatigue,and the inducing factors of insomnia referred to the treatment with endocrine therapy,anticipatory anxiety and inadequate sleep hygiene.All of the patients had received pharmacotherapy.The use proportion of non-pharmacological therapies was relatively low,and acupuncture was not chosen due to"not familiar with"and"fear of pain".Concerning to the preference for acupuncture,patients preferred the therapeutic methods of acupuncture with mild pain sensation and gentle stimulation;and the treatment should be more acceptable if delivered 2 or 3 times a week.Conclusion Breast cancer survivors have the expectations for sleep,and are willing to receive the treatment with medication for their sleep disorders.Because of lack of the knowledge for acupuncture effect on insomnia and fear of strong needling sensation,a part of patients are unwilling to be treated with acupuncture therapy,but they are expected to receive the treatment with acupuncture while feeling more comfortable.

关 键 词：乳腺癌幸存者 失眠认知 针灸治疗偏好 深度访谈 

分 类 号：R246.5[医药卫生—针灸推拿学]