基于症状管理理论模型的卵巢癌术后化疗患者症状体验及应对的质性研究

徐渴; 杨柳; 邓秀敏; 贾晨雨; 卢婷婷; 李金芝

doi:10.16766/j.cnki.issn.1674-4152.004390

基于症状管理理论模型的卵巢癌术后化疗患者症状体验及应对的质性研究

doi: 10.16766/j.cnki.issn.1674-4152.004390

1.
蚌埠医科大学护理学院，安徽蚌埠 233030
2.
蚌埠医科大学第一附属医院妇产科，安徽蚌埠 233004

基金项目:

安徽省教育厅人文社科重点研究项目 2022AH051414

蚌埠医科大学研究生创新创业项目 Byycx23037

详细信息

通讯作者:
李金芝，E-mail: 2639917769@qq.com

中图分类号: R737.31
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出版历程
- 收稿日期: 2025-02-07
- 网络出版日期: 2026-04-11

A qualitative study of symptomatic experience and coping in patients with postoperative chemotherapy for ovarian cancer based on symptom management theory model

1.
School of Nursing, Bengbu Medical University, Bengbu, Anhui 233030, China

摘要

摘要: 目的深入探究卵巢癌术后化疗患者的症状体验及应对策略，旨在为构建更精准且个体化的症状管理方案提供参考依据，从而帮助患者更有效地应对化疗带来的挑战，提升整体生活质量。方法采用质性研究中的现象学方法，于2023年10月—2024年2月通过目的抽样法对蚌埠医科大学第一附属医院妇瘤科17例卵巢癌术后化疗患者进行面对面的半结构式深度访谈。基于文献回顾并听取了专家意见，依据症状管理理论模型的3个核心方面，初步拟定了访谈提纲。通过预访谈，对提纲进行了修改，并最终确定了访谈提纲。采用Colaizzi 7步分析法通过反复阅读、比较、分析、推理和总结，归纳相似资料，最终形成主题。结果卵巢癌术后化疗患者症状体验及应对可归纳为三大主题：症状体验(多重生理症状、刻骨的心理创伤、社会经济方面)；症状管理策略(症状管理意识薄弱、症状管理需求较大、症状管理方式欠佳)；症状管理效果(消极应对症状、从容应对症状)。结论卵巢癌术后化疗患者症状负担涉及生理、心理及社会等多方面，患者在进行症状管理时仍面临较多阻碍和未满足的需求，因此，医护人员应关注患者的症状反应和应对需求，制定系统化的症状管理方案，加强心理疏导与居家支持，帮助其提高症状的自我管理意识和自我管理能力，改善生活质量。
- 卵巢癌术后化疗 /
- 症状管理 /
- 症状经历 /
- 定性研究
Abstract: Objective To explore the symptom experience and coping strategies of ovarian cancer patients undergoing postoperative chemotherapy, the study aims to provide a reference for constructing a more precise and individualized symptom management program, which will help patients more effectively address the challenges posed by chemotherapy and enhance their overall quality of life. Methods Using the phenomenological method in qualitative research, from October 2023 to February 2024, a semi-structured, in-depth face-to-face interview was conducted with 17 ovarian cancer patients undergoing postoperative chemotherapy in the Department of Gynecology at the First Affiliated Hospital of Bengbu Medical University. The participants were selected using an objective sampling method. Based on a literature review and expert opinions, an interview outline was developed, focusing on three core aspects of the symptom management theoretical model. After a pre-interview, the outline was revised and finalized. The Colaizzi 7-step analysis method was adopted to summarize similar data through repeated reading, comparison, analysis, reasoning, and summation, ultimately leading to the formation of themes. Results The symptom experience and response of postoperative chemotherapy patients with ovarian cancer can be summarized into three main themes: symptom experience (multiple physiological symptoms, deep psychological trauma, socio-economic aspects); symptom management strategies (weak awareness of symptom management, large need for symptom management, poor symptom management approach); symptom management effect (passive coping with symptoms, leisurely coping with symptoms). Conclusion The symptom burden of patients with postoperative chemotherapy for ovarian cancer involves physiological, psychological, and social aspects, and patients still face many obstacles and unmet needs in symptom management. Therefore, medical staff should pay attention to patients 'symptom response and response needs, develop systematic symptom management programs, and strengthen psychological counseling and home support to help them improve the self-management awareness of symptoms and self-management ability, and improve the quality of life.
- Postoperative chemotherapy for ovarian cancer /
- Symptom management /
- Symptom experience /
- Qualitative research

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表 1 各维度访谈提纲

Table 1. Interview outline for each dimension

维度		访谈提纲
症状体验	症状感知	1.您之前有了解过化疗后有哪些症状吗？
		2.化疗这段时间，您出现了哪些不适的症状？可以谈谈您是怎样看待这些症状的吗？
	症状评估	1.您可以具体描述一下症状表现吗？
	症状反应	1.您会向外界倾诉化疗症状时您的感受与体验吗？
症状管理策略		1.您过去采用过什么方式应对这些不适的症状？
		2.您是否需要医护人员或其他人给您提供相关帮助？
症状管理结果		1.您觉得您处理症状的方法是否有效？

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参考文献(20)

[1]	陈金玲, 冯元元, 饶珺. 血清C-反应蛋白与白蛋白比值对卵巢癌患者腹腔热灌注联合静脉化疗后短期预后的预测价值[J]. 新乡医学院学报, 2024, 41(4): 338-342. CHEN J L, FENG Y Y, RAO J. Effect of serum C-eactive protein-to-albumin ratio on short-term prognosis of ovarian cancerpatients after intraperitoneal hyperthermia combined with intravenous chemotherapy[J]. Journal of Xinxiang Medical University, 2024, 41(4): 338-342.
[2]	中国抗癌协会妇科肿瘤专业委员会. 卵巢上皮性癌一线化疗中国专家共识[J]. 实用妇产科杂志, 2022, 38(8): 582-588. Chinese Gynecologic Cancer Society. Chinese expert consensus on first-line chemotherapy for epithelial ovarian cancer[J]. J Pract Obstet Gynecol, 2022, 38(8): 582-588.
[3]	杨洁婷. 卵巢癌化疗患者症状群、恐惧疾病进展与生活质量的相关性研究[D]. 青岛: 青岛大学, 2022. YANG J T. Effect of symptom clusters and fear of progression on quality of life in patients with ovarian cancer chemotherapy[D]. Qingdao: Qingdao University, 2022.
[4]	唐月莲, 叶津津, 朱肖肖. 卵巢癌患者铂类药物化疗期间症状群及影响因素分析[J]. 中国妇幼保健, 2024, 39(1): 120-123. TANG Y L, YE J J, ZHU X X. Analysis of symptom groups and influencing factors during platinum-based chemotherapy in ovarian cancer patients[J]. Matern Child Health Care China, 2024, 39(1): 120-123.
[5]	LINDER L. Analysis of the UCSF symptom management theory: implications for pediatric oncology nursing[J]. J Pediatr Oncol Nurs, 2010, 27(6): 316-324. doi: 10.1177/1043454210368532
[6]	WEI J J, YAN H X, XIANG Y Q, et al. The Effectiveness of symptom management theory in guiding clinical practice-a systematic review[J]. Altern Ther Health Med, 2024, 30(8): 108-114.
[7]	中国抗癌协会妇科肿瘤专业委员会. 卵巢恶性肿瘤诊断与治疗指南(2021年版)[J]. 中国癌症杂志, 2021, 31(6): 490-500. Chinese Gynecologic Cancer Society. Guidelines for the diagnosis and treatment of malignant ovarian tumors (2021)[J]. China Oncol, 2021, 31(6): 490-500.
[8]	胡雁, 王志稳. 护理研究[M]. 6版. 北京: 人民卫生出版社, 2022: 266. HU Y, WANG Z W. Nursing research[M]. 6th edition. Beijing: People's medical publishing house, 2022: 266.
[9]	肖娟, 凌雅, 黄金华. 基于时机理论的极超低出生体重儿家庭支持护理需求的质性研究[J]. 中华全科医学, 2024, 22(9): 1609-1613. doi: 10.16766/j.cnki.issn.1674-4152.003694 XIAO J, LING Y, HUANG J H. Qualitative study on family support care needs of very low birth weight infant parents based on timing it right theory[J]. Chinese Journal of General Practice, 2024, 22(9): 1609-1613. doi: 10.16766/j.cnki.issn.1674-4152.003694
[10]	薛佳丽, 芦鸿雁, 余芳, 等. 老年慢性阻塞性肺疾病患者疲劳感知与应对体验的质性研究[J]. 中华全科医学, 2023, 21(5): 792-796. doi: 10.16766/j.cnki.issn.1674-4152.002985 XUE J L, LU H Y, YU F, et al. Perceived fatigue and coping experience in elderly patients with chronic obstructive pulmonary disease: a qualitative study[J]. Chinese Journal of General Practice, 2023, 21(5): 792-796. doi: 10.16766/j.cnki.issn.1674-4152.002985
[11]	赵亚楠. 基于网络分析的卵巢癌患者化疗期间症状群的研究[D]. 兰州: 兰州大学, 2023. ZHAO Y N. The research on symptom clusters in ovarian cancer patients receiving chemotherapy based on network analysis[D]. Lanzhou: Lanzhou University, 2023.
[12]	何亚林, 田亚林, 杜娟, 等. 卵巢癌化疗患者症状群与舒适状况及其相关性[J]. 西部医学, 2021, 33(6): 929-933. HE Y L, TIAN Y L, DU J, et al. Research on the status and correlation between symptom cluster andcomfort of patients with ovarian cancer undergoing chemotherapy[J]. Med J West China, 2021, 33(6): 929-933.
[13]	WU H J, CHUANG C M, CHIEN C H, et al. Changes in depression and sleep quality and associated factors in women receiving chemotherapy for ovarian cancer: an observational study[J]. Cancer Nurs, 2022, 45(4): 271-279. doi: 10.1097/NCC.0000000000000986
[14]	LUTGENDORF S K, PENEDO F, GOODHEART M J, et al. Epithelial-mesenchymal transition polarization in ovarian carcinomas from patients with high social isolation[J]. Cancer, 2020, 126(19): 4407-4413. doi: 10.1002/cncr.33060
[15]	SILVA L, LOPES V J, MERCÊS N. Symptom management theory applied to nursing care: scoping review[J]. Rev Bras Enferm, 2021, 74(3): e20201004. DOI: 10.1590/0034-7167-2020-1004.
[16]	DESHIELDS T L, PENALBA V, ARROYO C, et al. The relationship between response style and symptom reporting in cancer patients[J]. Support Care Cancer, 2023, 31(5): 312. DOI: 10.1007/s00520-023-07761-z.
[17]	MCDONOUGH M H, BESELT L J, KRONLUND L J, et al. Social support and physical activity for cancer survivors: a qualitative review and meta-study[J]. J Cancer Surviv, 2021, 15(5): 713-728. doi: 10.1007/s11764-020-00963-y
[18]	张璐, 官平, 鲁光洪, 等. 家庭韧性在卵巢癌患者自我感受负担与生命质量间的中介效应[J]. 现代预防医学, 2024, 51(2): 360-365. ZHANG L, GUAN P, LU G H, et al. Mediating effects of family resilience between self-perceived burden and quality of life in patients with ovarian cancer[J]. Mod Prev Med, 2024, 51(2): 360-365.
[19]	ZHANG S, LI J, HU X. Peer support interventions on quality of life, depression, anxiety, and self-efficacy among patients with cancer: a systematic review and meta-analysis[J]. Patient Educ Couns, 2022, 105(11): 3213-3224. doi: 10.1016/j.pec.2022.07.008
[20]	SHALABY R A H, AGYAPONG V I O. Peer support in mental health: literature review[J]. JMIR Ment Health, 2020, 7(6): e15572. DOI: 10.2196/15572.