口腔癌患者疾病不同阶段健康照护需求的质性研究  

Health care needs of oral cancer patients at different stages of the disease:a qualitative study

作　　者：白露 毕小琴[2] Bai Lu;Bi Xiaoqin(West China School of Nursing,Sichuan University,Chengdu 610041,China;National Key Laboratory of Oral Disease Prevention and Control&National Center of Stomatology&National Clinical Research Center for Oral Diseases&Orthognathic and Joint Surgery,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西护理学院,成都610041 [2]口腔疾病防治全国重点实验室、国家口腔医学中心、国家口腔疾病临床医学研究中心、四川大学华西口腔医院正颌及关节外科,成都610041

出　　处：《中华现代护理杂志》2025年第11期1494-1499,共6页Chinese Journal of Modern Nursing

基　　金：四川省科技计划项目(2022JDKP0007);成都市卫健委医学科研课题(2022015)。

摘　　要：目的基于时机理论探索口腔癌患者疾病不同阶段健康照护需求,为制订口腔癌患者健康照护方案提供参考。方法采用目的抽样法,选取2023年1—4月四川大学华西口腔医院头颈肿瘤外科住院患者为受访者。以时机理论为理论框架制订访谈提纲,通过半结构式访谈收集资料;采用内容分析法进行资料分析。结果综合口腔癌手术患者入院48 h内、术后3 d、术后7 d、出院后2周、出院后1个月5个阶段的健康照护需求内容,共提炼出7个主题和19个亚主题,即疾病相关信息支持(病情及诊疗方式、手术费用和医保报销);不良情绪疏导(手术焦虑感、诊疗无望感、复发恐惧感、自我价值感丧失);症状管理需求(口腔相关症状集群管理、个体化症状管理);健康照护技能指导(术后家属照护技能、口腔伤口护理、饮食营养护理);功能康复训练(口腔功能训练、运动功能训练);后续诊疗指导(异常情况就诊、复诊安排、放化疗准备知识指导、其他诊疗建议);自我管理需求(健康生活管理、应对策略)。结论口腔癌手术患者在术后1个月存在多种健康照护需求,建议医护人员对患者相关需求进行全面评估,对患者进行阶段化症状管理和个性化健康指导。Objective To explore the health care needs of oral cancer patients at different stages of the disease based on timing theory to provide a reference for developing health care programs for oral cancer patients.Methods Purposive sampling was used to select patients who were hospitalized in the Department of Head and Neck Tumor Surgery of West China Hospital of Stomatology,Sichuan University,from January to April 2023,as respondents.Timing theory was used as the theoretical framework to develop the interview outline,information was collected through semi-structured interviews,and content analysis was used to analyze the data.Results By synthesizing the health care needs of oral cancer patients with surgery at five stages of 48 hours after admission,three days after surgery,seven days after surgery,two weeks after discharge,and onemonth after discharge,seven themes and 19 sub-themes were extracted,including support for disease-related information(condition and treatment modalities,surgical costs,and reimbursement by medical insurance),alleviation of adverse emotions(surgical anxiety,hopelessness in diagnosis and treatment,fear of recurrence,and loss of self-worth),symptom management needs(management of oral-related symptom clusters,individualized symptom management),guidance on health care skills(postoperative family care skills,oral wound care,diet and nutritional care),and functional rehabilitation training(oral function training,motor function training),follow-up treatment guidance(consultation for abnormalities,arrangements for follow-up consultation,guidance on preparation for radiotherapy,and other treatment recommendations),and self-management needs(healthy life management,coping strategies).Conclusions Oral cancer patients with surgery have multiple healthcare needs in the first month after surgery.It is recommended that healthcare professionals conduct a comprehensive assessment of the patient's relevant needs and provide staged symptom management and personalized health guidance to the patient.

关 键 词：口腔肿瘤 时机理论 健康照护 需求 质性研究 

分 类 号：R473.73[医药卫生—护理学]