中晚期肺癌患者就医延迟体验的质性研究

Qualitative study on delayed experience of seeking medical treatment in patients with advanced lung cancer

目的探讨中晚期肺癌患者就医延迟的原因和感受,为开展更具针对性的健康教育和护理服务提供新思路。方法采用目的抽样法选取2021年11—12月在广西医科大学第一附属医院就医延迟的30例中晚期肺癌患者为研究对象,基于计划行为理论对患者进行半结构式深度访谈,应用Colaizzi现象学分析法和Nvivo11.0软件对访谈内容进行分析与提炼。结果30例中晚期肺癌患者就医延迟时间在90~213 d,通过类属分析法提炼出4个主题群:就医延迟原因、就医原因、对疾病的忧虑和解决方案。结论中晚期肺癌患者就医延迟受症状严重程度、家庭经济能力、社会支持水平、卫生服务可及性、新型冠状病毒疫情等外部情景因素和病耻感、负担感重等个人主观心理因素的影响,需通过多渠道多样化的综合管理策略来改善中晚期肺癌患者的就医延迟行为。

Objective To explore the causes and feelings of delayed experience of seeking medical treatment in patients with advanced lung cancer,and to provide new insights for more targeted health education and medical care services.Methods A semi-structured in depth interview based on the theory of planned behavior was conducted among 30 patients with advanced lung cancer who experienced medical delay from November to December in 2021 admitted to First Affiliated Hospital of Guangxi Medical University.The interview content was analyzed and abstracted by using Colaizzi phenomenological analysis method and Nvivo11.0 software.Results The delay duration of 30 patients with advanced lung cancer ranged from 90 to 213 days.Four subject groups were extracted by generic analysis:the cause of delay,the cause to seek medical help,the worry about the disease,and solutions.Conclusions The delay behavior of patients with advanced lung cancer is affected by external situational factors such as symptom severity,family economic capacity,social support,accessibility of health services,prevalence of novel coronavirus,and subjective psychological factors such as sense of stigma and burden of disease,it is necessary to reduce the occurrence of medical delay in patients with advanced lung cancer through the comprehensive management strategy of multiple channels.