儿科医护人员癌症病情告知的概念分析  

Healthcare professionals'cancer disclosure in pediatric oncology:A hybrid concept analysis

作　　者：谢润 黄晓燕[1] 顾莺[2] 康琼芳 王慧美[2] 于玲 XIE Run;HUANG Xiaoyan;GU Ying;KANG Qiongfang;WANG Huimei;YU Ling(School of Nursing,Fudan University,Shanghai 200032,China;Children's Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学护理学院,上海200032 [2]复旦大学附属儿科医院,上海201102

出　　处：《中国循证儿科杂志》2025年第2期131-138,I0041-I0045,共13页Chinese Journal of Evidence Based Pediatrics

基　　金：复星护理科研基金项目:FNF202352。

摘　　要：背景在医学领域,“癌症病情告知”并不是一个新概念,但在儿科领域缺少明确定义。目的分析儿科医护人员癌症病情告知的概念及内涵。设计混合概念分析法(包括理论阶段、质性阶段和分析阶段)。方法①理论阶段:以范围综述形式检索PubMed、Cochrane Library、中国知网、维普数据等9个数据库,纳入研究内容为儿科肿瘤医生或护士对患儿或家长进行癌症病情告知,研究结局包括但不限于儿童癌症病情告知的概念属性、影响因素、后果及癌症病情告知相近概念的文献;排除重复文献,语言非中文或英文,或无法获取全文的文献。构建并提取儿科医护人员癌症病情告知概念框架和相近概念。②质性阶段:根据范围综述提取的概念框架、咨询专家意见和预访谈,构建访谈提纲,对复旦大学附属儿科医院肿瘤工作的医生和护士进行半结构化深度访谈,对访谈文本内容进行编码转录,采用主题分析法编码和提炼主题。③分析阶段:比较和整合理论阶段和质性阶段的结果,得出最终的概念定义和框架内容。主要结局指标儿科医护人员癌症病情告知概念的定义和框架。结果①范围综述共纳入16篇英文文献,构建儿科医护人员癌症病情告知概念框架(包括核心概念属性、前置因素和后置影响),相关概念包括癌症诊断告知、预后相关告知、终末期讨论。②半结构化访谈20名儿童肿瘤科医护人员(护士和医生各10名),平均访谈时长(46.2±10.2)min,主题分析法逐级提取3个一级主题和11个二级主题。与相近概念辨析发现癌症病情告知概念具有普适性。③最终将儿科医护人员癌症病情告知概念定义为儿科医护人员与患儿及其家庭成员(通常为患儿父母)在整个动态变化的癌症轨迹中准确地针对患儿个体性的诊断、检查、治疗、护理、康复、预后等病情相关的多元信息而开展的人文性沟通。核Background Cancer disclosure is not a new concept in medicine,however,there is no clear definition of this term in pediatric oncology.Objective To analyze the concepts and connotations of cancer disclosure among pediatric healthcare professionals.Design Hybrid concept analysis(including theoretical phase,qualitative phase,analytical phase).Methods①Theoretical phase:A scoping review was conducted by search 9 databases,including PubMed,Cochrane Library,CNKI,and VIP Database,etc.Studies focused on pediatric oncologists or nurses communicating cancer diagnoses to children or their parents,with outcomes including(but not limited to)conceptual attributes,influencing factors,consequences of cancer disclosure,and literature on related concepts.Duplicates,non-Chinese/English studies,and unavailable full texts were excluded.A conceptual framework in pediatric oncology practice was developed and related terms for cancer disclosure was extracted.②Qualitative phase:Based on the conceptual framework extracted from the scoping review,expert consultations,and pre-interviews,a semi-structured interview guide was developed.In-depth interviews were conducted with doctors and nurses working in pediatric oncology at the Children's Hospital of Fudan University.The interview transcripts were coded and analyzed using thematic analysis to identify and refine key themes.③Analytical phase:Results from the theoretical and qualitative phases were integrated to refine the final conceptual definition and framework.Main outcome measures Definition and framework of the concept of healthcare professionals'cancer disclosure in pediatric oncology.Results①The scoping review included 16 English studies,establishing a conceptual framework(core attributes,antecedents,and consequences)and identifying related terms:diagnosis disclosure,prognosis-related communication,and end-of-life discussions.②Interviews with 20 pediatric oncology professionals(10 nurses,10 doctors;mean interview duration 46.2±10.2 min)yielded 3 primary themes and 11 subthem

关 键 词：混合概念分析 儿科 肿瘤学 病情告知 

分 类 号：R473.72[医药卫生—护理学]