晚期癌症患者临终期真实体验的质性研究

Qualitative Study of the True Experiences in Terminal Stage of Advanced Cancer Patients

目的深入了解晚期癌症患者临终期的真实体验。方法 2015年7-12月,采用目的抽样法选择上海市某三级甲等医院中医科病房的30例住院癌症患者为研究对象,采用诠释现象学研究方法对其进行半结构式访谈,现场录音,根据诠释学循环原则对转录资料进行主题分析。结果晚期癌症患者临终期的真实体验可归纳为3个类属10个主题,类属一:个人方面,即拖累感、担忧、恐惧、自我封闭;类属二:社会家庭方面,即经济负担、婚姻不幸、癌症歧视;类属三:治疗方面,即求医困难、不良反应大、沟通障碍。结论晚期癌症患者临终期常存在不良情绪及较重的经济负担,医护人员应加强与患者的沟通,积极采取针对性的措施,提高患者的社会支持水平,减轻或消除患者的不良情绪。

[Abstract ] Objective To deeply understand the true experiences of advanced cancer patients in the termi-nal stage.Methods Hermeneutic phenomenology was used to carry out the semi-structured interview with 30 advanced cancer patients with onsite record,and the data were analyzed to extract the themes.Results Three themes and ten subthemes were extracted,including personal factors（be a burden to the family,wor-ry,fear,self-reclusive）;social and family aspects（economic burden,unhappy marriage and cancer discrimi-nation）;treatments aspect（difficult to seeking medical advice,great side effects and communication barri-ers）.Conclusions Advanced cancer patients in their terminal stage usually had bad emotions and relatively heavy economic burden.Medical care personnel should enhance the communication with patients and take targeted countermeasures,and improve patient’s social support level,thus to reduce or eliminate patient’ s negative emotions.