血液系统恶性肿瘤患者接受CAR-T治疗心理体验的研究

Study on the psychological experience of patients with hematological malignancies receiving CAR-T therapy

目的描述接受嵌合抗原受体T细胞(CAR-T)治疗的恶性肿瘤患者在治疗前后的心理体验,为临床心理护理工作提供可参考信息。方法采用质性研究方法,对20名CAR-T治疗后患者进行访谈,采用内容分析法进行资料分析。结果患者在接受CAR-T治疗时存在多种心理体验,主要分为2个主题,即积极的心理体验和消极的心理体验。患者在不同时间的心理体验不尽相同,治疗前积极的心理体验包括:信任、希望、庆幸、理性。治疗后积极的心理体验包括:喜悦、满意、满怀信心。治疗前消极的心理体验包括:无奈、不信任、担心。治疗后消极的心理体验包括:顾虑、否认、后悔、不平衡感、悲伤、失望。结论接受CAR-T治疗前患者的积极心理体验较多,治疗后患者因治疗效果不同而产生不同的心理体验。医护人员应了解患者在不同治疗阶段的心理感受,识别患者的心理状态,为其提供个性化的心理支持。

Objective To describe the psychological experience of patients treated with chimeric antigen receptor T-cells(CAR-T)in Department of Hematology before and after treatment,so as to provide reference for clinical psychological nursing care.Methods In the current study,qualitative research methods were adopted.Data were collected from 20 patients after CAR-T treatment through interviews,and the data were analyzed by content analysis.Results During CAR-T treatment,patients had a variety of psychological experiences,which can be mainly divided into two parts:positive psychological experience and negative psychological experience.Patients might obtain various psychological experiences at different time points.Positive psychological experiences before treatment included trust,hope,rejoicing and rationality.Positive psychological experiences at the end of the treatment included joy,satisfaction,and confidence.Negative psychological experiences before treatment included helplessness,mistrust and worry.Negative psychological experiences at the end of treatment included concern,denial,regret,imbalance,sadness and disappointment.Conclusions Patients receiving CAR-T therapy present more positive psychological experiences before treatment,with different psychological experiences due to various therapeutic effects after treatment.Medical staff should understand the psychological feelings of patients at different treatment stages,identify their psychological states,and provide them with individualized psychological supports.