结核病患者居家化疗相关症状管理体验的质性研究  

Qualitative study on the symptom management experience of tuberculosis patients undergoing home-based chemotherapy

作　　者：王佳 王秀华[2] 矫晓克 陈晓凤 马伟光[1] Wang Jia;Wang Xiuhua;Jiao Xiaoke;Chen Xiaofeng;Ma Weiguang(School of Nursing,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100144,China;Department of Nursing,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China;Department of Tuberculosis I,Bejing Chest Hospital,Capital Medical University,Beijing 101149,China;Department of Intensive Care Unit,Beijing Chest Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]中国医学科学院北京协和医学院护理学院,北京100144 [2]首都医科大学附属北京胸科医院护理部,北京101149 [3]首都医科大学附属北京胸科医院结核一科,北京101149 [4]首都医科大学附属北京胸科医院重症监护室,北京101149

出　　处：《中华现代护理杂志》2025年第12期1574-1581,共8页Chinese Journal of Modern Nursing

摘　　要：目的为了解结核病患者居家抗结核化疗相关症状的管理体验及需求。方法本研究为描述性质性研究。采用目的抽样法,于2024年3-7月选取曾于首都医科大学附属北京胸科医院就诊的居家服药化疗的结核病患者及具有结核病工作经验的医护人员为受访者,围绕化疗相关症状的管理体验及管理需求进行半结构式访谈,采用主题分析法进行资料分析。结果共访谈13例结核病患者和6名医护人员。最终提炼出4个核心主题:多重共现症状加重居家疾病管理难度与多维困扰;结核病患者自我症状管理能力不足;居家化疗症状管理需求高且表现多样;院外随访与监管体系难以有效应对症状管理。结论结核病患者居家化疗相关症状管理负担重且难度大,未来应通过加强院外延续性护理、开发特异性症状评估工具、构建家庭和医院联合的高效多症状综合管理策略改善结核病患者化疗相关症状管理体验及管理效果。Objective To explore the symptom management experience and needs of tuberculosis patients undergoing home-based anti-tuberculosis chemotherapy.Methods This was a descriptive qualitative study.Purposeful sampling was used to select tuberculosis patients receiving home-based chemotherapy and healthcare professionals with tuberculosis experience from Beijing Chest Hospital,Capital Medical University between March and July 2024.Semi-structured interviews focused on the management experience and needs related to chemotherapy symptoms.Data were analyzed using thematic analysis.Results A total of 13 tuberculosis patients and six healthcare professionals were interviewed.A total of four core themes were identified:multiple concurrent symptoms exacerbate the difficulty of home disease management and cause multidimensional distress;tuberculosis patients have insufficient self-management skills for symptoms;there is a high and diverse demand for symptom management during home chemotherapy;and the out-of-hospital follow-up and monitoring system struggles to address symptom management effectively.Conclusions Tuberculosis patients undergoing home chemotherapy face significant and challenging symptom management burdens.Future improvements should include enhancing continuity of care outside the hospital,developing specific symptom assessment tools,and establishing an efficient,multi-symptom integrated management strategy combining home and hospital care to improve symptom management experience and outcomes for tuberculosis patients.

关 键 词：结核 症状管理 体验 药物不良反应 质性研究 

分 类 号：R52[医药卫生—内科学]