乳腺癌相关淋巴水肿患者综合消肿治疗依从性的质性研究

doi:10.3761/j.issn.0254-1769.2023.07.002

摘要/Abstract

摘要：

目的深入了解乳腺癌相关淋巴水肿患者综合消肿治疗（complete decongestive therapy，CDT）依从性的障碍因素与促进因素。方法基于健康行动过程取向理论，采用目的抽样法，于2021年9月—2022年2月选取13例接受CDT的乳腺癌相关淋巴水肿患者进行半结构式访谈，采用内容分析法分析资料。结果 CDT依从性的障碍因素包括危险感知不足、消极的结果预期、自我效能感低、缺乏行为意图、缺少行动及应对计划，促进因素包括感知到治疗益处、重建社交自信、感知到水肿的危害、自我效能感增强、激发治疗动机、构建生活新常态。结论乳腺癌相关淋巴水肿患者CDT的依从性受一系列障碍及促进因素的影响，今后可基于健康行动过程取向理论制订针对性的干预策略，提高其治疗依从性。

关键词: 乳腺肿瘤, 淋巴水肿, 综合消肿治疗, 障碍因素, 促进因素, 护理

Abstract:

Objective To explore the barriers and facilitators factors of adherence to complete decongestive therapy（CDT） in patients with breast cancer related lymphedema（BCRL）. Methods Based on the Health Action Process Approach theory，from September 2021 to February 2022，12 patients with BCRL undergoing CDT were purposely selected for semi-structured in-depth interviews. Data were collected and analyzed using the Colaizzi seven-step analysis method. Results The extracted barriers of CDT included insufficient risk perception，negative outcome expectation，low self-efficacy，lack of behavioral intention，lack of action and coping plan. The facilitators included perceived benefits of treatment，perceived harm of edema，enhanced self-efficacy，motivation of treatment，and construction of a new normal life. Conclusion The adherence of CDT in patients with BCRL is affected by a series of barriers and facilitators. In the future，targeted intervention strategies can be formulated based on the theory of health action process approach to improve the treatment adherence.

Key words: Breast Neoplasm, Lymphedema, Complete Decongestive Therapy, Barriers, Facilitators, Nurs-ing Care

武佩佩, 王盈, 沈傲梅, 强万敏, 杨惠莉, 刘鑫鑫. 乳腺癌相关淋巴水肿患者综合消肿治疗依从性的质性研究[J]. 中华护理杂志, 2023, 58(7): 781-787.

WU Peipei, WANG Ying, SHEN Aomei, QIANG Wanmin, YANG Huili, LIU Xinxin. Barriers and facilitators of adherence to complete decongestive therapy in patients with breast cancer related lymphedema：a theory-based qualitative study[J]. Chinese Journal of Nursing, 2023, 58(7): 781-787.

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