转移性脊柱肿瘤患者治疗决策旅程地图的研究  

The treatment decision journey map in patients with metastatic spinal tumors

作　　者：李雪 秦林灿 童博姗 唐棠 罗春梅 Li Xue;Qin Lincan;Tong Boshan;Tang Tang;Luo Chunmei(Department of Gynecology and Obstetrics,the Second Affiliated Hospital of Army Military Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院妇产科,重庆400037 [2]陆军军医大学护理系 [3]陆军军医大学第一附属医院呼吸与危重症医学科 [4]陆军军医大学第二附属医院骨科

出　　处：《护理学杂志》2025年第3期40-45,共6页Journal of Nursing Science

基　　金：2023年重庆市科卫联合医学科研项目(2023MSXM011)。

摘　　要：目的 基于旅程地图识别转移性脊柱肿瘤患者治疗决策的多维需求,为满足该群体的决策需求提供借鉴。方法 运用描述性质性研究方法,选取17例转移性脊柱肿瘤患者进行半结构式深度访谈,采用内容分析法进行资料分析并绘制患者旅程地图。结果 按诊疗时间轴,从任务、触点、情绪和痛点4个维度将转移性脊柱肿瘤患者的治疗决策需求归纳为健康意识薄弱、就诊选择困难、治疗方案理解困难、信息获取与甄别面临困难、治疗反应困扰等32条主题,其中就诊筛查期11条、治疗决策期11条、治疗期10条。结论 转移性脊柱肿瘤患者治疗决策旅程复杂,其就诊选择、治疗决策、症状管理需求凸显。建议规范网络健康信息及开发医疗评价平台,构建以护士主导、家庭参与的网络交互式治疗决策辅助工具,应用电子患者报告结局系统实施智慧症状管理,以满足患者围治疗决策期的健康需求。Objective To identify the multidimensional needs of treatment decision-making in patients with metastatic spinal tumors based on the journey map,and to provide a reference for meeting the decision-making needs of this group.Methods A descriptive qualitative study was designed,and 17 patients with metastatic spinal tumors were selected to conduct semi-structured in-depth interviews,then the content analysis method was used to analyze the interview data and draw the journey map.Results According to the timeline of diagnosis and treatment,from the four dimensions of task,touch point,emotion,and pain point,the treatment decision-making needs of patients with metastatic spinal tumors were summarized into 32 themes:weak health consciousness,difficulty in seeking medical treatment,difficulty in understanding treatment plan,difficulty in acquiring and distinguishing information,treatment related symptom distress,etc.,which were categorized into screening period(11 items),treatment decision-ma-king period(11 items) and treatment period(10 items).Conclusion The treatment decision-making journey in patients with metastatic spinal tumors is complex,and their needs for treatment selection,treatment decision-making,and symptom management are prominent.It is suggested to standardize online health information,develop a medical evaluation platform,build a nurse-led and family-involved online interactive patient decision aid,and apply the Electronic Patient-reported Outcome(ePRO) to implement intelligent symptom management,so as to meet the health needs of patients during the pretreatment decision-making period.

关 键 词：脊柱肿瘤 治疗决策 旅程地图 症状管理 健康需求 质性研究 

分 类 号：R473.6[医药卫生—护理学]