中重度尊严缺失晚期癌症患者尊严维护需求的质性研究

A qualitative study on needs for maintenance of dignity in patients with advanced cancer experiencing moderate to severe loss of dignity

目的了解中重度尊严缺失晚期癌症患者尊严维护需求,为更好地维护其尊严提供参考。方法对10例中重度尊严缺失晚期癌症患者进行半结构式深度访谈,采用现象学研究方法进行资料分析、提炼主题。结果共提炼出3个主题及10项下属内容:疾病相关尊严维护需求(维持独立水平,免受生理症状困扰,维护知情及自主权),家庭社会支持需求(家庭支持,病友沟通,医疗支持),心理灵性关怀需求(角色维护,保持自我价值,活在当下,传承奉献)。结论晚期癌症患者尊严维护需求呈现症状控制、相对独立与陪伴、知情参与及安宁需求等特征,医护人员应根据需求实施针对性个体化的尊严维护与实现。

Objective To understand needs for maintenance of dignity in patients with advanced cancer experiencing moderate to severe loss of dignity, and to provide reference for better maintenance of their dignity. Methods A semi-structured in-depth interview was conducted at 10 patients with advanced cancer who experienced moderate to severe loss of dignity, then data were analyzed to extract themes using phenomenological method. Results Three themes including 10 subthemes were identified: disease-related dignity maintenance needs (maintenance of independence, avoidance of symptom distress, and maintenance of informed right and autonomy);family social support needs (family support, peer communication, and medical support);and psychological spiritual care needs (role maintenance, maintenance of self-worth, living in the moment, and inheritance/dedication). Conclusion Needs for maintenance of dignity in advanced cancer patients include symptom control, relative independence and companionship, informed participation and tranquility. Medical staff should provide patient-centered interventions to maintain their dignity.