食管癌患者对影响营养的症状体验研究

doi:10.3761/j.issn.0254-1769.2025.19.011

摘要/Abstract

摘要：

目的探究诊疗期间食管癌患者对影响营养症状的真实体验，为制订营养管理策略提供参考。方法采用目的抽样法，选取2024年10—12月广州市某三级甲等医院胸外科收治的15例食管癌患者进行半结构式访谈，使用主题分析法进行资料分析。结果共提炼出4个主题、12个亚主题。①存在多种症状感知：食道梗阻-吞咽困难、食欲影响症状、多症状叠加、症状感知存在个体化差异。②症状认知存在不足：高估症状可控性、症状归因偏差。③产生负性情绪反应：对进食的焦虑与恐惧、因进食功能下降产生的挫败感、对失去进食掌控感的无助与愧疚。④症状应对策略多样：回避性应对、适应性应对、积极开展营养管理。结论食管癌患者的营养影响症状体验具有复杂性和多样性，医护人员应及时识别并评估营养影响症状，提供营养健康教育，加强心理疏导，制订具有文化特色的个性化营养管理策略。

关键词: 食管癌, 影响营养症状, 症状体验, 质性研究, 护理

Abstract:

Objective To explore the real experiences of nutrition impact symptoms in esophageal cancer patients during diagnosis and treatment，and to provide references for developing nutritional management strategies. Methods Using purposive sampling，15 esophageal cancer patients admitted to the thoracic surgery department of a tertiary grade A hospital in Guangzhou from October to December 2024 were selected for semi-structured interviews. Thematic analysis was used for data analysis. Results 4 themes and 12 sub-themes were identified：①Multiple symptom perceptions：esophageal obstruction-dysphagia，appetite-affecting symptoms，multiple symptom over-lap，and individual differences in symptom perception. ②Insufficient symptom cognition：overestimation of symptom controllability and biased symptom attribution. ③Negative emotional reactions：anxiety and fear about eating，frustration with declining eating function，and helplessness and guilt about losing control over eating. ④Di-verse symptom coping strategies：avoidance coping，adaptive coping，and active nutritional management. Conclusion The nutrition impact symptom experiences of esophageal cancer patients are complex and diverse. Healthcare professionals should promptly identify and assess nutrition impact symptoms，provide nutrition health education，strengthen psychological guidance，and develop culturally distinctive individualized nutritional management strategies.

Key words: Esophageal Cancer, Nutrition Impact Symptoms, Symptoms Experience, Qualitative Research, Nursing Care

程慕习, 廖慧艳, 黎辉, 贺雨欣, 钟蕾, 宋新慧, 李梅. 食管癌患者对影响营养的症状体验研究[J]. 中华护理杂志, 2025, 60(19): 2378-2383.

CHENG Muxi, LIAO Huiyan, LI Hui, HE Yuxin, ZHONG Lei, SONG Xinhui, LI Mei. A qualitative study on the experiences of nutrition impact symptoms in esophageal cancer patients[J]. Chinese Journal of Nursing, 2025, 60(19): 2378-2383.

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