The cognition and experience of concurrent radio-chemotherapy in patients with nasopharyngeal carcinoma (NPC):a qualitative research
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摘要: 目的 探讨同期放化疗的鼻咽癌患者认知和体验,为促进鼻咽癌患者身心康复提出有效干预和实施措施。 方法 采用目的抽样方法,于2015年10月—2016年2月对广西某市三级甲等医院13例鼻咽癌患者进行半结构式访谈,根据Colaizzi七步分析法对原始资料进行整理分析。 结果 同期放化疗的鼻咽癌患者认知可分为3个主题:对同期放化疗治疗本质的认识感觉困惑;从病友同期放化疗症状中感觉恐惧;从病友的治疗效果中期盼接受治疗。对同期放化疗的体验归纳为6个主题:采取积极的措施预防同期放化疗的毒副反应;同期放化疗的压力很大;自己无法坚持完成整个治疗;希望同期放化疗快点结束;期待与外界加强交流;渴望知道自己病情进展及预后的相关知识。 结论 鼻咽癌患者对同期放化疗具有连续、动态的认知和多种体验并存。治疗期间患者随着治疗的副反应和身心不适不断加重,导致心理状态和生活质量较低。因此护理人员应该提供个体化、全面的支持性照护,消除患者的恐惧、焦虑等不良心理,促使患者的情绪由负性逐渐向正性转变;加强鼻咽癌患者整个治疗的自我防护与教育,树立患者治疗的信心;增强家庭、社会及医护支持系统的作用,鼓励家属参与患者同期治疗后的心理体验,从而有利于促进患者心理健康,提高其生活质量。Abstract: Objective To investigate concurrent radio-chemotherapy patients with NPC over the same cognition and experience in order to provide effective intervention and implementation measures of improving the patients physical and mental rehabilitation. Methods Semi-structured interviews were conducted to a total of 13 patients with NPC in a major hospital in Nanning and the data were explored via Colaizzi seven-step analysis. Results The perception of concurrent radiochemotherapy patients could be classified into 3 themes:the cognitive confusion by knowing the nature of concurrent radio-chemotherapy; experiencing fear by the same period of concurrent radio-chemotherapy patients; expecting treatment because of effective treatments of other patients. The experience of concurrent radio-chemotherapy could be extracted into 6themes:taking active measures to prevent the toxic and side effect; having great pressure of the concurrent radio-chemotherapy; unable to finish the whole therapy; hoping for a quick end; looking forward to exchanges with the outside; expecting information of the progress and prognosis. Conclusion The concurrent radio-chemotherapy patients have continuous and dynamic cognition coexisting with various experience. The patients' mental state and quality of life lowered along with the toxic and side effects in concurrent radio-chemotherapy, so nursing staff should provide individualized, comprehensive supportive care to eliminate the patient's fear, anxiety and help shift patients mood from negative to positive; strengthen the protection and the treatment of patients with education, establishing the confidence of patients; enhance the effect of family, society and medical support system, encouraging family members to participate, thus to promote the patients' psychological health and improve their quality of life.
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Key words:
- Nasopharyngeal carcinoma /
- Concurrent radio-chemotherapy /
- Cognition /
- Experience /
- Qualitative research
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