老年肺癌患者微波消融术后症状体验的质性研究

A qualitative study of symptom experience in elderly patients with lung cancer after microwave ablation

中文关键词: 老年  肺癌  微波消融  症状体验  质性研究

英文关键词: elderly  lung cancer  microwave ablation  symptom experience  qualitative study

中文摘要:

      目的 探究老年肺癌患者微波消融术后症状体验,以期为临床患者的术后症状管理提供新思路.方法 应用目的抽样法,选取2023年12月—2024年3月在南京医科大学第一附属医院进行治疗的老年肺癌患者作为研究对象.通过半结构式访谈法采集资料,在结束访谈24 h内,通过回放方式将谈话内容逐句转录,依据症状管理理论将原始的访谈资料形成三级编码,依据开放式、主轴式和选择式的编码形式,通过不断对比,最终得到三级编码框架.结果 通过提炼总结得到老年肺癌患者微波消融术后症状体验4个主题,分别为多样性的症状感知、对症状体验认知不足、症状体验的影响、症状体验的应对策略.在多样性的症状感知中,所有患者均感觉有全身症状,8例患者有呼吸系统的症状,9例患者有消化系统症状.对症状体验认知不足中,多数患者对专业信息理解困难,并对症状表示出忽视与忍耐.患者的症状体验影响了日常生活、人际交往和情绪体验.在症状体验的应对策略中,部分患者表现得消极沮丧,多数患者希望得到家庭和社会的支持.结论 老年肺癌患者微波消融术后症状体验较差,医护人员应加强对患者的症状管理与评估等,建立多方位的支持干预体系,协助患者更好地应对临床症状.

英文摘要:

      Objective To explore the symptom experience of elderly patients with lung cancer after microwave abla-tion,and provide a new idea for the postoperative symptom management of clinical patients.Methods According to purposive sampling method,the elderly patients with lung cancer treated in First Affiliated Hospital of Nanjing Medical University from December 2023 to March 2024 were selected as the research subjects.Their data were collected by semi-structured interview method.Within 24 h of the end of the interview,the content of the interview was transcribed sentence by sentence through playback.The original interview data was formed into three-level coding according to the symptom management theory.Based on the open,axial,and selective coding forms,a three-level coding framework is finally obtained through continuous compari-son.Results Four themes of symptom experience after microwave ablation in elderly patients with lung cancer were summa-rized.They were the diversity of symptom perception,insufficient cognition of symptom experience,influence of symptom ex-perience,and coping strategies of symptom experience.In the diverse symptom perceptions,all patients felt systemic symp-toms,8 ones had respiratory symptoms,and 9 ones had digestive symptoms.In the insufficient cognition of symptom experi-ence,most patients had difficulty in understanding professional information,and showed neglect and patience to symptoms.The symptom experience of patients affected their daily life,social interactions,and emotional experiences.In the coping strat-egies of symptom experience,some patients were negative and depressed,and most patients hoped to get support from family and society.Conclusion Elderly patients with lung cancer have poor symptom experience after microwave ablation.Medical staff should strengthen the symptom management and evaluation of patients,and establish a multi-directional support and inter-vention system to help them better cope with clinical symptoms.