二元视角下晚期癌症患者和家庭照顾者灵性应对体验的质性研究

Spiritual coping experiences in advanced cancer patients and family caregivers from a dyadic perspective:a qualitative study

目的基于二元视角,深入了解晚期癌症患者及其家庭照顾者在应对癌症过程中灵性应对方式,为开展针对患者和照顾者的二元协同灵性照护干预提供依据。方法以目的抽样法,选取中医肿瘤科12对晚期癌症患者及其家庭照顾者为研究对象,采用现象学研究法进行半结构式访谈,运用Colaizzi分析法和二元数据分析法分析资料。结果共提炼出5个主题:接纳当下(接受现实、心怀希望、看淡生死)、超越自我(感悟人生、承担责任、珍爱自我)、与外界联系(感知家庭温暖、寻求心灵支撑、感激他人)、超脱现实(维持正常生活、寄托信仰、亲近自然)、消极应对(质疑命运、丧失期望)。结论晚期癌症患者和家庭照顾者在应对癌症过程中多采用积极的灵性应对方式,两者的灵性应对具有相似性,且相互影响。医护人员可将患者及照顾者作为一个整体,制定并实施针对性的灵性照护方案,以提高二者的灵性健康及生活质量水平。

Objective Based on a dyadic perspective,to understand deeply the experiences of spiritual coping in advanced cancer patients and family caregivers,and provide a basis for the formulation family caregiver-cancer patient dyads collaborative spiritual care program.Methods Twelve dyads of patients with advanced cancer and their family caregivers were selected by using purposeive sampling method in the department of TCM oncology,and semi-structured interviews were conducted.Colaizzi analysis and dyadic data analysis method were used to analyze the data.Results Five themes were extracted:accepting the present(accepting the reality,fostering hope,accepting death),self-transcendence(enlightening life,taking responsibility,loving oneself),connecting with the outside world(feeling family warmth,seeking spiritual support,being grateful to others),transcending reality(maintaining normal life,putting hope in faith,getting close to nature),responding negatively(questioning fate,losing expectations).Conclusion Patients with advanced cancer and family caregivers mostly adopted positive spiritual coping ways in the process of dea-ling with cancer.The spiritual coping experiences of them were similar and mutually influencing each other.Medical staff should treat patients and caregivers as a whole,formulate and implement targeted spiritual care programs,in an effort to improve dyadic spiritual health and quality of life.