晚期癌症患者家属安宁疗护决策体验的质性研究

doi:10.3761/j.issn.0254-1769.2023.13.004

摘要/Abstract

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

逄天宇, 袁玲, 武丽桂, 周玉洁, 王丹若, 周智, 颜恺然, 孙露露. 晚期癌症患者家属安宁疗护决策体验的质性研究[J]. 中华护理杂志, 2023, 58(13): 1559-1564.

PANG Tianyu, YUAN Ling, WU Ligui, ZHOU Yujie, WANG Danruo, ZHOU Zhi, YAN Kairan, SUN Lulu. Qualitative study on palliative care decision-making experience of family members of patients with advanced cancer[J]. Chinese Journal of Nursing, 2023, 58(13): 1559-1564.

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