肺癌患者参与新辅助免疫治疗临床试验的决策体验与需求的质性研究

Decision-making experience and needs of patients in clinical trials of neoadjuvant immunotherapy for lung cancer:a qualitative study

目的深入探索参与新辅助免疫治疗临床试验的肺癌患者的决策体验。方法采用描述性质性研究方法,于2021年4月—2022年8月采用目的抽样法选取在中国医学科学院肿瘤医院参与新辅助免疫治疗临床试验的15例肺癌患者进行半结构式深入访谈,并以内容分析法进行资料的分析、总结与归纳。结果共提炼出3个主题:决策信息困境(信息不足或超载、专业信息理解困难、亟需决策信息辅助)、复杂情绪体验(负性情绪体验、正性情绪体验)、希望得到多方支持(期待心理沟通、希冀家人理解、渴望社会认可)。结论总结并描述参与新辅助免疫治疗临床试验的肺癌患者的决策体验,有助于加强研究团队医护人员对此类患者决策时真实体验的了解,以此提供针对性决策支持策略,促进患者人群良好的知情同意。

Objective To deeply explore the decision-making experience of patients participating in clinical trials of neoadjuvant immunotherapy for lung cancer.Methods Using the descriptive and qualitative research,15 lung cancer patients who participated in clinical trials of neoadjuvant immunotherapy at the Cancer Hospital of the Chinese Academy of Medical Sciences were selected by purposive sampling from April 2021 to August 2022 for semi-structured in-depth interviews.Content analysis method was used for data analysis,summarization,and induction.Results Three themes were extracted,namely decision-making information dilemma(insufficient or overloaded information,difficulty in understanding professional information,urgent need for decision-making information assistance),complex emotional experience(negative emotional experience,positive emotional experience),and hope for multi-party support(expecting psychological communication,hoping for family understanding,and longing for social recognition).Conclusions The decision-making experience of patients in clinical trials of neoadjuvant immunotherapy for lung cancer were summarized and described,which can help strengthen the understanding of the research team and medical and nursing staff on the live experience of such patients when making decisions,provide targeted decision support strategies,and promote good informed consent of patients.