膀胱癌术后维持膀胱灌注化疗患者自我超越体验的质性研究  

Self-Transcendence Experiences in Postoperative Bladder Cancer Patients Undergoing Maintenance Intravesical Chemotherapy:a Qualitative Study

作　　者：陈诗倩 林媛珍[2] 朱倩 胡庆霞[3] 程城[2] CHEN Shi-qian;LIN Yuan-zhen;ZHU Qian;HU Qing-xia;CHENG Cheng(School of Nursing,Nanchang University,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Urology,the Second Affiliated Hospital of Nanchang University the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Wound and Ostomy Clinic,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学护理学院,南昌330006 [2]南昌大学第二附属医院泌尿外科,南昌330006 [3]南昌大学第二附属医院伤口造口门诊,南昌330006

出　　处：《实用临床医学(江西)》2025年第1期93-99,共7页Practical Clinical Medicine

基　　金：江西省科学技术厅重点研发项目(20202BBGL73073)。

摘　　要：目的 探讨膀胱癌术后维持膀胱灌注化疗患者的自我超越体验,为制订相关护理干预策略,提高此类患者的精神健康及生存质量提供依据。方法 采用描述性现象学研究方法,通过目的抽样选取2023年7—9月在南昌大学第二附属医院就诊的13位膀胱癌术后维持膀胱灌注化疗患者为研究对象进行半结构式访谈,应用Colaizzi7步分析法分析提炼资料。结果 患者的自我超越体验可提炼出4个主题与10个亚主题:主动接纳疾病并有效自我调整与扩展(能进行良好的角色行为适应、发展兴趣爱好以实现生命的意义、感觉积极学习可缓解焦虑并提升幸福感);愿意与他人相互支持以稳定生活质量(努力实现工作与治疗的平衡、生活的重心转移至家庭、继续坚持经营自身社交圈、愿意用自身经验帮助他人);产生新的人生态度;阻碍自我超越的因素(经济压力、缺乏家庭支持、行动力不足及知识缺乏)。结论 护理人员应对维持膀胱灌注化疗患者的自我超越体验予以更多的关注与重视。针对患者自我超越中的阻碍因素,及时为患者提供帮助与指导,选择合适的干预手段帮助其提升自我超越。Objective To explore the self-transcendence experiences of postoperative bladder cancer patients undergoing maintenance intravesical chemotherapy,with the aim of informing the development of targeted nursing interventions to enhance psychological well-being and quality of life in this population.Methods A descriptive phenomenological approach was employed.13 patients receiving maintenance intravesical chemotherapy after bladder cancer surgery at the Second Affiliated Hospital of Nanchang University from July to September 2023 were purposively sampled for semi-structured interviews.Data were analyzed and synthesized using Colaizzi’s 7-step phenomenological analysis framework.Results Patients’self-transcendence experiences were categorized into 4 primary themes with 10 subthemes:proactive disease acceptance and adaptive self-adjustment(effective behavioral adaptation to roles;cultivating hobbies to affirm life meaning;perceived anxiety alleviation and enhanced well-being through active learning);reciprocal social support to stabilize quality of life(balancing work and treatment;shifting life priorities toward family;sustaining social engagement;altruistic sharing of experiential knowledge);emergence of renewed life perspectives;impediments to self-transcendence(financial burden;inadequate familial support;inertia and knowledge deficits).Conclusion Nursing practitioners must prioritize the identification and reinforcement of self-transcendence experiences in patients undergoing maintenance intravesical chemotherapy.Tailored interventions should address context-specific barriers to self-transcendence through timely provision of assistance,guidance,and evidence-based strategies to foster adaptive resilience.

关 键 词：膀胱癌 膀胱灌注化疗 自我超越 质性研究 护理 

分 类 号：R473.6[医药卫生—护理学]