Abstract:

Objective This study aims to explore the real self-management experience of cancer patients after chemotherapy on home fall prevention and to identify influencing factors of implementing self-management on home fall prevention,so as to provide references for the further construction of intervention strategies. Methods The purpose sampling method was used,and a total of 20 cancer patients treated with chemotherapy were interviewed by semi-structured in-depth interviews. Themes were identified and analyzed by Nancy phenomenological method. Results The overall ability of cancer patients after chemotherapy to prevent falls at home is poor. After chemotherapy,cancer patients had problems with the knowledge about self-management of home fall prevention,the skills of home fall prevention and poor compliance of self-management. The themes,including the hopelessness for disease recovery,the lack of information on prevention of falls at home and limited condition,were found to be the most common barriers for implementing fall prevention measures,while the support from nurses/family members and strongly healthy responsibility were motivating factors for patients to prevent falls at home. Conclusion Understanding the perception of home fall prevention for chemotherapy patients provides the information for education of fall prevention and assists nurses to form strategies and measures to promote patients safety.

Key words: Fall, Neoplasms, Chemotherapy, Patients Safety, Community Nursing, Qualitative Study

摘要：

目的 探究肿瘤患者化疗后居家跌倒预防自我管理的真实体验,明确肿瘤患者化疗后实施居家跌倒预防自我管理的阻碍及促进因素,为构建肿瘤患者化疗后居家跌倒预防自我管理干预策略提供参考依据。方法 采用目的抽样方法,2018年11月—12月对武汉市某三级甲等医院肿瘤内科20例化疗后肿瘤患者进行半结构式深入访谈,并运用Nancy现象学7步分析法进行资料分析。结果 肿瘤患者化疗后在进行居家跌倒预防自我管理时,存在居家跌倒预防自我管理认识不足、居家跌倒预防技能欠缺以及自我管理行为依从性差的问题;阻碍患者主动实施居家跌倒预防自我管理的因素包括患者对疾病预后及治疗效果的无望感、居家跌倒预防自我管理信息支持不足、客观条件受限,而家属/医护人员的支持监督、对个人健康及家庭的责任感是其主动实施居家跌倒预防自我管理的行为动力。结论 肿瘤患者化疗后居家跌倒预防自我管理能力及自我管理行为依从性欠缺,迫切需要构建相关策略以提升其居家跌倒预防自我管理能力,减少不良事件发生。

关键词: 跌倒, 肿瘤, 化学治疗, 患者安全, 社区护理, 质性研究