胃癌术后化疗患者癌性厌食自我管理体验的质性研究  

Qualitative study on self-management experiences of cancer-related anorexia in patients undergoing chemotherapy after gastric cancer surgery

作　　者：张银珠 张培莉[1] 侯晓雅 武晓茹 金雅茹 高超越 李滢 Zhang Yinzhu;Zhang Peili;Hou Xiaoya;Wu Xiaoru;Jin Yaru;Gao Chaoyue;Li Ying(School of Nursing,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学护理学院,山西太原030001 [2]山西医科大学第一医院肿瘤消化科 [3]浙江大学医学院附属第一医院泌尿外科 [4]上海健康医学院护理与健康管理学院

出　　处：《护理学杂志》2024年第24期47-51,共5页Journal of Nursing Science

基　　金：山西省教育厅2023年度研究生教育教学改革基金项目(2023JG087)。

摘　　要：目的了解胃癌术后化疗患者癌性厌食自我管理的真实体验,为制订癌性厌食规范化自我管理方案提供参考。方法采用描述性质性研究方法,对20例胃癌术后化疗患者进行半结构式深入访谈,并采取主题分析法,通过Nvivo12 Plus软件对访谈资料进行编码、分析和提炼主题。结果胃癌术后化疗患者癌性厌食自我管理体验可归纳为3个主题及9个亚主题,即自我管理知识欠缺(饮食自我管理认知不足、动态营养支持的认知不足),自我管理相关障碍因素(服药依从性差、饮食依从性差、自我感受负担重),自我管理的积极态度和行为动力(患者改善食欲的期望、改变饮食习惯、对个人健康及家庭的责任感、增强自我效能感)。结论胃癌术后化疗患者癌性厌食自我管理存在诸多困难,医护人员应实施具有针对性的营养教育,关注患者心理变化,探索适合胃癌术后化疗患者癌性厌食自我管理的新模式,从而提高其癌性厌食的自我管理能力。Objective To understand the real experiences of self-management of cancer-related anorexia in patients undergoing chemotherapy after gastric cancer surgery,and to provide a reference for developing standardized self-management programs for cancer-related anorexia.Methods A descriptive qualitative research method was employed to conduct semi-structured in-depth interviews with 20 patients undergoing chemotherapy after gastric cancer surgery.Thematic analysis was performed using Nvivo 12 Plus software for coding,analysis,and theme refinement.Results The self-management experiences of cancer-related anorexia in patients after gastric cancer surgery were summarized into three main themes and nine sub-themes:lack of self-management knowledge(insufficient understanding of dietary self-management,insufficient understanding of dynamic nutritional support),related barriers to self-management(poor medication adherence,poor dietary adherence,heavy burden of self-perception),and positive attitudes and motivational behaviors toward self-management(patients′expectations for appetite improvement,changes in dietary habits,sense of responsibility for personal health and family,enhanced self-efficacy).Conclusion Patients undergoing chemotherapy after gastric cancer surgery face numerous difficulties in self-managing cancer-related anorexia.Healthcare professionals should implement targeted nutritional education,pay attention to patients′psychological changes,and explore new models for self-management of cancer-related anorexia suitable for these patients to enhance their self-management capabilities.

关 键 词：胃肿瘤 化疗 癌性厌食 自我管理 营养素养 营养教育 营养护理 质性研究 

分 类 号：R473.73[医药卫生—护理学]