中华护理杂志 ›› 2023, Vol. 58 ›› Issue (13): 1559-1564.DOI: 10.3761/j.issn.0254-1769.2023.13.004

• 安宁疗护专题 • 上一篇    下一篇

晚期癌症患者家属安宁疗护决策体验的质性研究

逄天宇(), 袁玲(), 武丽桂, 周玉洁, 王丹若, 周智, 颜恺然, 孙露露   

  1. 210023 南京市 南京中医药大学护理学院(逄天宇,颜恺然);南京中医药大学鼓楼临床医学院肿瘤科(袁玲);南京大学医学院附属鼓楼医院肿瘤科(武丽桂,周玉洁,王丹若,孙露露);南京医科大学附属明基医院缓和医学科(周智)
  • 收稿日期:2023-01-29 出版日期:2023-07-10 发布日期:2023-06-29
  • 通讯作者: 袁玲,E-mail:yuanling73@hotmail.com
  • 作者简介:逄天宇:女,本科(硕士在读),E-mail:pangty_982608@163.com
  • 基金资助:
    南京鼓楼医院护理科研一般项目(2023-A705)

Qualitative study on palliative care decision-making experience of family members of patients with advanced cancer

PANG Tianyu(), YUAN Ling(), WU Ligui, ZHOU Yujie, WANG Danruo, ZHOU Zhi, YAN Kairan, SUN Lulu   

  • Received:2023-01-29 Online:2023-07-10 Published:2023-06-29

摘要:

目的 探索晚期癌症患者家属在参与安宁疗护决策时的体验,为制订决策辅助策略提供依据。 方法 采用目的抽样法,于2022年12月—2023年1月对南京市2所三级甲等医院安宁疗护病房收治的12例晚期癌症患者的家属进行半结构式访谈,运用Colaizzi 7步分析法对访谈资料进行分析、归纳并提炼主题。 结果 共提炼出3个主题及9个亚主题:①复杂的决策感受,包括无助感、犹豫不决、内心坚定;②缺乏有效的决策支持,包括安宁疗护相关信息的可及性低、医患间信息不对称、医护人员的安宁疗护宣传意识薄弱;③多重决策动机,包括满足患者的舒适需求、缓解家庭的照顾负担、减轻经济压力。 结论 晚期癌症患者家属在安宁疗护决策过程中的体验复杂,医护人员应不断提高安宁疗护实践能力,有针对性地为晚期癌症患者家属提供决策支持,改善其决策体验,促进安宁疗护的实施。

关键词: 癌症, 家属, 安宁疗护, 决策体验, 质性研究

Abstract:

Objective To explore the real experience of family members of advanced cancer patients in participating in palliative care decision-making,and to provide evidence for making decision-making assistant strategies. Methods Using the method of objective sampling,the semi-structured interview was conducted with family members of patients with advanced cancer from December 2022 to January 2023. Colaizzi 7-step analysis method was used to analyze,summarize,integrate and refine the data. Results A total of 3 themes and 9 sub-themes were extracted. Theme 1:complex decision-making experience(helplessness,hesitation,determination). Theme 2:lack of decision-making information and communication(low accessibility of palliative care information,information asymmetry between doctors and patients, weak awareness of promoting palliative care of medical staff). Theme 3:multiple decision motivation(meeting patient comfort needs,alleviating family care burden,reducing economic burden). Conclusion The decision-making of palliative care for the families of advanced cancer patients is a complex process. Medical staff should continuously improve their palliative care capabilities,provide targeted decision-making support for the families,optimize the decision-making experience and promote the implementation of palliative care.

Key words: Cancer, Family Members, Palliative Care, Decision-Making Experience, Qualitative Research