乳腺癌患者参加新辅助治疗临床试验真实体验的质性研究

Qualitative research on the real experience of breast cancer patients participating in the clinical trial of neoadjuvant therapy

目的:了解乳腺癌患者参加新辅助治疗临床试验的真实体验,为参加新辅助治疗临床试验的乳腺癌患者的个性化护理提供参考。方法:采取目的抽样法,选取2022年7月至10月参加新辅助治疗临床试验的13例乳腺癌患者为研究对象,进行半结构式访谈。结果:提炼出3个主题,分别为对临床试验认知差异显著(盲目质疑和抵触、过分依赖和期待、科学对待和认识)、心理体验沉重或释然(迷茫与恐惧、自卑与羞耻、感谢与庆幸、适应与成长)及寻求科普和支持(对治疗知识的渴望、期待医护人员关心和同伴支持)。结论:参加新辅助治疗临床试验的乳腺癌患者缺乏专业科普途径和支持力量,其真实体验受认知影响,感受差异显著。临床护士应评估参加新辅助治疗临床试验的乳腺癌患者的需求,个性化宣教纠正认知偏差,辅助正确决策,予以人文关怀改善负性情绪,协同医护、家庭、社会支持力量使患者在创伤后成长。

Objective:To understand the real experience of breast cancer patients participating in the clinical trial of neoadjuvant therapy,so as to provide basis for personalized nursing of breast cancer patients participating in the clinical trial of neoadjuvant therapy.Methods:Thirteen breast cancer patients who participated in the clinical trial of neoadjuvant therapy from July to October 2022 were selected as the research subjects by objective sampling,and semi-structured interviews were conducted.Results:Three themes were extracted including significant differences in cognition of clinical trials(blind questioning and resistance,excessive dependence and expectation,scientific treatment and understanding),heavy or relieved psychological experience(confusion and fear,inferiority and shame,gratitude and happiness,adaptation and growth),and seeking for science popularization and support(desire for treatment knowledge,expectation of medical care and peer support).Conclusion:Breast cancer patients who participated in the clinical trial of neoadjuvant therapy lacked professional science popularization approach and support,and their real experience was affected by cognition,with significant differences in feelings.Clinical nurses should assess the needs of breast cancer patients who participate in the clinical trial of neoadjuvant therapy,conduct personalized education to correct cognitive bias and assist in correct decision-making.Clinical staffs should give humanistic care to decrease negative emotions,and cooperate with medical care,family and social support forces to allow patients to grow after trauma.