癌症患者自我管理行为转变体验质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2024.07.015

摘要/Abstract

摘要：

目的系统评价与整合癌症患者自我管理行为转变的体验，为后续制订针对性的自我管理干预措施提供依据。方法计算机检索Cochrane Library、CINAHL、Embase、PubMed、Web of Science、PsycINFO、中国知网、维普数据库、万方数据库和中国生物医学文献数据库中有关癌症患者自我管理行为转变体验的质性研究，检索时限为建库至2023年7月。采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准进行文献质量评价，采用汇集性整合的方法进行结果整合。结果共纳入12篇文献，提炼出50个研究结果，归纳成14个新类别，合成4个整合结果：自我管理行为的转变形式、自我管理行为的转变特征、自我管理行为转变的动力因素、自我管理行为转变的阻碍因素。结论医护人员应关注癌症患者自我管理行为转变的真实体验，根据自我管理行为转变特征及影响因素进行针对性的能力培养和心理干预，促进其自我管理行为的顺利转变。

关键词: 肿瘤, 自我管理行为, 转变, 质性研究, 循证护理学

Abstract:

Objective To systematically evaluate the self-management behavior transformation experience of cancer patients，providing a basis for the subsequent development of targeted self-management intervention measures. Methods Qualitative studies related to self-management behavior transformation experience of cancer patients from Cochrane Library，CINAHL，Embase，PubMed，Web of science，PsycINFO，and China National Knowledge Infras-tructure，VIP Database，Wanfang Database，and China Biomedical Literature Database were searched by computer，with a search deadline of July 2023. The literature quality evaluation was conducted using the qualitative research quality evaluation standards of the Evidence Based Health Care Center at the Joanna Briggs Institute in Australia，and the results were integrated using a pooled integration method. Results A total of 12 articles were included，and 50 research results were extracted and summarized into 14 new categories. 4 integrated results were synthesized，including the forms of self-management behavior transformation，the characteristics of self-management behavior transformation，the driving factors of self-management behavior transformation，and the obstacles to self-management behavior transformation. Conclusion Medical staff should pay attention to the real experience of cancer patients’ self-management behavior transformation. Targeted ability cultivation and psychological intervention can be carried out based on the characteristics and influencing factors of cancer patients’ self-management behavior transformation，promoting their smooth transformation of self-management behavior.

Key words: Neoplasms, Self-Management, Transition, Qualitative Research, Evidence-Based Nursing

林雯雯, 徐梅, 夏云, 江宁, 莫瑜威, 王莉, 宁丽. 癌症患者自我管理行为转变体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(7): 865-872.

LIN Wenwen, XU Mei, XIA Yun, JIANG Ning, MO Yuwei, WANG Li, NING Li. Meta-synthesis of qualitative research on the experience of self-management behavior changes for cancer patients[J]. Chinese Journal of Nursing, 2024, 59(7): 865-872.

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参考文献 31

[1]	郑荣寿, 陈茹, 韩冰峰, 等. 2022年中国恶性肿瘤流行情况分析[J]. 中华肿瘤杂志, 2024, 46(3):221-231.
	Zheng RS, Chen R, Han BF, et al. Prevalence of malignant tumors in China in 2022[J]. Chin J Cancer, 2024, 46(3): 221-231.
[2]	Allemani C, Matsuda T, di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14(CONCORD-3):analysis of individual records for 37513025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries[J]. Lancet, 2018, 391(10125):1023-1075. DOI PMID
[3]	李京京, 吕晓晴, 刘杉杉, 等. 围手术期肺癌患者症状群与生活质量相关性的纵向研究[J]. 中华护理杂志, 2020, 55(11):1635-1641. DOI URL
	Li JJ, Lü XQ, Liu SS, et al. A longitudinal study on the correlations between symptom clusters and quality of life in patients with lung cancer during perioperation[J]. Chin J Nurs, 2020, 55(11):1635-1641. DOI URL
[4]	张旭, 孙迪, 李小寒, 等. 癌症患者复发恐惧的潜在剖面分析[J]. 中华护理杂志, 2023, 58(6):662-669. DOI URL
	Zhang X, Sun D, Li XH, et al. Fear of recurrence in cancer patients:a latent profile analysis[J]. Chin J Nurs, 2023, 58(6):662-669.
[5]	Howell DD. Supported self-management for cancer survivors to address long-term biopsychosocial consequences of cancer and treatment to optimize living well[J]. Curr Opin Support Palliat Care, 2018, 12(1):92-99. DOI URL
[6]	Kim SH, Kim K, Mayer DK. Self-management intervention for adult cancer survivors after treatment:a systematic review and meta-analysis[J]. Oncol Nurs Forum, 2017, 44(6):719-728. DOI URL
[7]	Costanzo ES, Lutgendorf SK, Roeder SL. Common-sense beliefs about cancer and health practices among women completing treatment for breast cancer[J]. Psychooncology, 2011, 20(1):53-61. DOI PMID
[8]	Wu FL, Howell D, Fang Q, et al. Trajectory patterns and factors influencing self-management behaviors in Chinese patients with breast cancer[J]. Cancer Nurs, 2020, 43(2):E105-E112. DOI URL
[9]	胡雁. 循证护理学[M]. 北京: 人民卫生出版社, 2012.
	Hu Y. Evidence-based nursing[M]. Beijing: People’s Medical Publishing House, 2012.
[10]	Sureepom C, Hunsa S, Ratanawadee C, et al. Health behavior changes among survivors of breast cancer after treatment completion[J]. Pacific Rim Inter J Nurs Res, 2020, 24(4):472-484.
[11]	Tang JWC, Lam WWT, Ma ASY, et al. Dietary changes adopted by Chinese colorectal cancer patients:a qualitative study[J]. Eur J Cancer Care, 2019, 28(6):e13159.
[12]	Lim JW, Gonzalez P, Wang-Letzkus MF, et al. Health behavior changes following breast cancer treatment:a qualitative comparison among Chinese American,Korean American,and Mexican American survivors[J]. J Health Care Poor Underser-ved, 2013, 24(2):599-618.
[13]	Nolan TS, Ivankova N, Carson TL, et al. Life after breast can-cer:‘being’ a young African American survivor[J]. Ethn Health, 2022, 27(2):247-274. DOI URL
[14]	Ching SSY, Mok ESB. Adoption of healthy lifestyles among Chinese cancer survivors during the first five years after completion of treatment[J]. Ethn Health, 2022, 27(1):137-156. DOI URL
[15]	Tsay SL, Ko WS, Lin KP. The lifestyle change experiences of cancer survivors[J]. J Nurs Res, 2017, 25(5):328-335. DOI URL
[16]	Beghean R, Coffey L. “You either sink or You swim,and you’re better off swimming”:a qualitative study exploring the self-management experiences of soft tissue sarcoma survivors[J]. Eur J Oncol Nurs, 2021, 55:102062. DOI URL
[17]	Pereira C, Pinto B, Muniz R, et al. Falling ill and surviving breast cancer:the experience of mastectomized woman[J]. R Pesq Cuid Fundam Online, 2013, 5(2):3837-3846. DOI URL
[18]	Hardcastle SJ, Maxwell-Smith C, Zeps N, et al. A qualitative study exploring health perceptions and factors influencing participation in health behaviors in colorectal cancer survivors[J]. Psychooncology, 2017, 26(2):199-205. DOI PMID
[19]	Hardcastle SJ, Glassey R, Salfinger S, et al. Factors influencing participation in health behaviors in endometrial cancer survivors[J]. Psychooncology, 2017, 26(8):1099-1104. DOI PMID
[20]	Webb LA, McDonnell KK. Not a death sentence:perspectives of African American women living with lung cancer[J]. Oncol Nurs Forum, 2018, 45(1):46-54. DOI URL
[21]	Tsai E, Robertson MC, Lyons EJ, et al. Physical activity and exercise self-regulation in cancer survivors:a qualitative study[J]. Psychooncology, 2018, 27(2):563-568. DOI URL
[22]	董朝晖, 卢惠娟, 陆箴琦, 等. 癌症患者社会疏离体验的质性研究[J]. 中华护理杂志, 2023, 58(6):670-675. DOI URL
	Dong ZH, Lu HJ, Lu ZQ, et al. Experiences of social isolation in cancer patients:a qualitative research[J]. Chin J Nurs, 2023, 58(6):670-675.
[23]	Chien CH, Huang XY. Self-care experiences of advanced pros-tate cancer survivors who underwent androgen deprivation therapy[J]. Cancer Nurs, 2022, 45(3):190-200. DOI URL
[24]	Liang MY, Chen QY, Zhou YY. The influence of various role models on children’s pro-environmental behaviours[J]. Front Psychol, 2022, 13:873078. DOI URL
[25]	Hernandez Silva E, Lawler S, Langbecker D. The effectiveness of mHealth for self-management in improving pain,psy-chological distress,fatigue,and sleep in cancer survivors:a systematic review[J]. J Cancer Surviv, 2019, 13(1):97-107. DOI
[26]	Taylor C, Richardson A, Cowley S. Restoring embodied control following surgical treatment for colorectal cancer:a longitu-dinal qualitative study[J]. Int J Nurs Stud, 2010, 47(8):946-956. DOI URL
[27]	石习习, 王静, 杨雪琴. 癌症患者心理痛苦预测模型的构建及验证[J]. 中华护理杂志, 2022, 57(11):1330-1336. DOI URL
	Shi XX, Wang J, Yang XQ. Construction and validation of risk prediction model of psychological distress in patients with cancer[J]. Chin J Nurs, 2022, 57(11):1330-1336. DOI URL
[28]	Michie S, van Stralen MM, West R. The behaviour change wheel:a new method for characterising and designing beha-viour change interventions[J]. Implement Sci, 2011, 6:42. DOI PMID
[29]	Howell D, Mayer DK, Fielding R, et al. Management of cancer and health after the clinic visit:a call to action for self-management in cancer care[J]. J Natl Cancer Inst, 2021, 113(5):523-531. DOI PMID
[30]	锁蓉飞, 颜君, 张丽娟. 癌症宿命论的研究进展[J]. 中华护理杂志, 2019, 54(10):1588-1592. DOI URL
	Suo RF, Yan J, Zhang LJ. Research progress of cancer fata-lism[J]. Chin J Nurs, 2019, 54(10):1588-1592.
[31]	O’Connor P, Di Carlo M, Rouleau JL. The leadership and or-ganizational context required to support patient partnerships[J]. Healthc Q, 2018, 21(SP):31-37.