Abstract:

Objective To explore the problems and causes of disease communication between colorectal cancer patients and their spouses,and to provide a basis for further interventions.Methods Purposive sampling method was used to select patients with colorectal cancer from September to December 2019 in a tertiary hospital in Zhengzhou for semi-structured interviews. Data was analyzed by Colaizzi method.Results 4 themes were extracted. Theme 1 is negative communication problems during the treatment（including heavy communication burden of male patients,the lack of emotional support in communication content,couples avoidance of cancer-related topics）. Theme 2 is positive communication experience in the rehabilitation period（including positive communication about the new life after illness,the increasing of the sense of tacit understanding）. Theme 3 is the influence of negative communication on patients（including the increased negative emotions,the increased inner loneliness of patients,the decline of self-confidence,the conflicts caused by over protection of spouses）. Theme 4 is patients’ expectation of effective communication between the husband and wife（including the obtaining of professional knowledge guidance to improve communication efficiency,the hope to get training in communication skills）.Conclusion There are differences in disease communication of couples in different stages of ostomy patients with colorectal cancer. Negative communication will have a negative effect on the patient’s psychological status. Therefore,nurses should pay attention to such patients and give effective interventions.

Key words: Colorectal Cancer, Enterostomy, Spouse, Disease Communication, Qualitative Research, Nursing Care

摘要：

目的 探讨结直肠癌患者夫妻疾病沟通体验,为进一步促进夫妻间有效沟通提供依据。方法 采用目的抽样法,选取2019年9月—12月在郑州市某三级甲等医院治疗和复诊的结直肠癌造口患者进行半结构式访谈,并用Colaizzi 7步分析法分析资料。结果 共提炼4个主题,治疗期消极沟通体验主题包括男性患者缺乏沟通意识、缺乏情感沟通、避免沟通敏感话题;康复期积极沟通体验主题包括积极沟通患病后新生活、沟通默契感增加;消极沟通对患者的影响主题包括负性情绪增加、内心孤独感增加、自信心下降、配偶过度保护产生矛盾;患者对夫妻有效沟通的期待主题包括获得专业知识指导,提高沟通效能以及希望获得沟通技能培训。结论 结直肠癌造口患者不同阶段夫妻疾病沟通体验存在差异,消极沟通会对患者心理产生负面影响,医护人员应关注此类患者,给予有效干预措施。

关键词: 结直肠癌, 肠造口术, 配偶, 疾病沟通, 质性研究, 护理