癌症手术患者及其配偶二元应对体验的质性研究

Dyadic coping experience of patients undergoing cancer surgery and their spouses:a qualitative study

目的分析癌症手术患者及其配偶二元应对体验,为癌症患者及其配偶的心理护理提供依据。方法采用目的抽样法,选取在河南省某三级甲等综合医院首诊为癌症并采取手术治疗的16例患者及其配偶作为研究对象,对其二元应对体验进行3个月个案纵向追踪访谈,运用Colaizzi 7步分析法对访谈资料进行归纳并提炼主题。结果共提炼出8个主题即:诊断期应激反应强烈、独自应对压力、一致的求医态度;围手术期应对能力不足、相处关系的改变;居家康复期疾病信息缺乏、沟通技巧欠缺、创伤后共同成长。结论癌症手术患者及其配偶的二元应对体验呈现阶段性不同的特征,医护人员应根据不同阶段的二元应对体验给予针对性护理,以促进癌症患者及其配偶共同身心康复。

Objective To investigate the dyadic coping experience of patients undergoing cancer surgery and their spouses.Methods Sixteen cancer patients who were initially diagnosed with cancer and underwent cancer surgery in a general hospital in Henan province as well as and their spouses were selected as the study subjects by objective sampling method.All the patients and their spouses were included in the postoperative follow-up for dyadic coping experiences though a 3 months interview.The acquired data were summarised and analysed by Colaizzi’s phenomenological method to identify relevant themes.Results A total of eight themes were identified,including three themes over the phase of confirmed diagnosis,strong stress response,coping with stress alone and consistent attitude towards seeking medical treatment;two themes over the perioperative phase,lack of coping ability and change in relationship;and three themes over the phase of home recovery,lack of disease information,poor communication skills and post-trauma growth of both patient and spouse.Conclusions The dyadic coping experience of patients who undergo cancer surgery and their spouses varies with the stages across the treatment.Therefore,medical staff should offer targeted nursing care according to the dyadic coping experience at different stages,hence to improve the physical and mental health of the cancer patients and their spouses.