专业照护者感知的癌症患儿向成人过渡影响因素的质性研究

doi:10.3761/j.issn.0254-1769.2022.09.004

摘要/Abstract

摘要：

目的深入了解专业照护者感知的影响癌症患儿向成人过渡的因素,为提升患儿的过渡期准备度提供参考依据。方法 2020年9月—2021年6月,应用现象学研究方法,对来自上海市、广州市、安徽省4所儿童专科医院的5名医生、19名护士、3名社会工作者进行半结构式深度访谈,对访谈资料进行转录、编码、分析、提炼主题。结果专业照护者感知的影响癌症患儿向成人过渡的因素可归纳为4个主题：患儿因素（诊疗经历、疾病认知、自主性）;家庭因素（过渡意识、教养方式）;医疗系统因素（专业团队、专业服务）;社会因素（社会环境、保障体系）。结论癌症患儿向成人过渡受多种因素影响,需要提高社会各层面对该问题的关注度,鼓励患儿知晓疾病信息、参与疾病管理,提升专业照护者的服务能力,加强长期随访的连续性,发展服务体系,制订适合国内临床情景的个性化干预措施,促进患儿和家长有效应对疾病和治疗的远期影响。

关键词: 癌, 过渡期护理, 影响因素, 质性研究, 儿科护理学

Abstract:

Objective To explore the influencing factors of the transition to adults on children with cancer from the perspective of professional care providers,so as to improve their transition readiness. Methods From September 2020 to June 2021,by phenomenological research methods,semi-structured in-depth interviews were conducted with 5 doctors,19 nurses and 3 social workers. The interview data were transcribed,coded,analyzed and refined. Results From the perspective of professional care providers,the factors influencing the transition of children with cancer can be summarized into 4 factors,i.e. individual,family,medical system and society,and 9 sub-factors,i.e. diagnosis and treatment experience,disease cognition,autonomy,transitional consciousness,education style,professional team,profes-sional service,social environment and service system. Conclusion There are multiple factors influencing the transition to adulthood. To assist them to effectively cope with the long-term impact of disease and treatment,it is necessary to raise the public attention,encourage children to be informed and participate in disease management,upgrade professionals’ capabilities,strengthen the continuity of long-term follow-up,develop the service system,and develop individualized and targeted intervention adapted to Chinese situations.

Key words: Carcinoma, Transitional Care, Influence Factors, Qualitative Research, Pediatric Nursing

成磊, 钱佳艺, 段明霞, 黄海英, 王颖雯. 专业照护者感知的癌症患儿向成人过渡影响因素的质性研究[J]. 中华护理杂志, 2022, 57(9): 1048-1053.

CHENG Lei, QIAN Jiayi, DUAN Mingxia, HUANG Haiying, WANG Yingwen. A qualitative study of professional care providers’ perception on influencing factors of the transition to adulthood on children with cancer[J]. Chinese Journal of Nursing, 2022, 57(9): 1048-1053.

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