恶性肿瘤患儿治疗期间体力活动阻碍因素的质性研究
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摘要
目的深入了解恶性肿瘤患儿治疗期间体力活动的阻碍因素,以期为制订针对性的干预措施提供参考。方法 2017年6-9月,采用目的抽样法选择就诊于广州市某肿瘤防治中心的6例恶性肿瘤患儿及11例患儿家属为研究对象,运用质性研究中的现象学方法,对其进行深度访谈,并采用Colaizzi分析法进行资料分析。结果恶性肿瘤患儿治疗期间体力活动的阻碍因素可归纳为4个类属8个主题:疾病与治疗引起的不适症状;长时间输液及治疗设备的限制;传统动静观念;康复优先;患儿性格及情绪变化;家属的顺从心态;医院环境的影响;周围人群对患儿体力活动的影响。结论医护人员须关注患儿疾病与治疗状况对其体力活动的影响,针对患儿及家属体力活动的错误认知开展健康教育,提供活动设施及场地,并给予具体的心理指导,从而改善恶性肿瘤患儿的体力活动情况。
Objective To explore the barriers of physical activity for children with malignant tumor during treatment, in order to provide reference for the formulation of targeted interventions.Methods Phenomenology was adopted, 6 children with malignant tumor and 11 caregivers were recruited, and in-depth interviews were conducted, the data were analyzed by Colaizzi method.Results The findings indicated that the barriers of physical activity for children with malignant tumor during treatment included four aspects and eight themes: the symptoms of discomfort caused by illness and treatment, the limitation of long-term infusion and treatment equipment, the traditional concept of movement, the priority of rehabilitation, changing of children's personality and mood, the obedience of family members, the impact of hospital environment and the influence of surrounding population on physical activity of children.Conclusion Medical staff should pay attention to the influence of illness and treatment on physical activity of children, and carry out health education for the children and their families with the wrong perception of physical activity. Medical staff also need to monitor psychological changes of the children and their families, give them psychological guidance, and regularly carry out physical activities in the ward, so as to improve the physical activities of children with malignant tumors.
Objective To explore the barriers of physical activity for children with malignant tumor during treatment, in order to provide reference for the formulation of targeted interventions.Methods Phenomenology was adopted, 6 children with malignant tumor and 11 caregivers were recruited, and in-depth interviews were conducted, the data were analyzed by Colaizzi method.Results The findings indicated that the barriers of physical activity for children with malignant tumor during treatment included four aspects and eight themes: the symptoms of discomfort caused by illness and treatment, the limitation of long-term infusion and treatment equipment, the traditional concept of movement, the priority of rehabilitation, changing of children's personality and mood, the obedience of family members, the impact of hospital environment and the influence of surrounding population on physical activity of children.Conclusion Medical staff should pay attention to the influence of illness and treatment on physical activity of children, and carry out health education for the children and their families with the wrong perception of physical activity. Medical staff also need to monitor psychological changes of the children and their families, give them psychological guidance, and regularly carry out physical activities in the ward, so as to improve the physical activities of children with malignant tumors.
引文
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[15]LAM K K,HO C W L,HO K Y,et al.Factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer:an exploratory study[J].J Clin Nurs,2017,26(1-2):190-201.
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[17]MENDOZA J A,BAKER K S,MORENO M A,et al.A fitbit and facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors:a pilot study[J].Pediatric Blood Cancer,2017,64(12):9.
[18]CHENG L A,MENDONCA G,FARIAS J J.Physical activity in adolescents:analysis of the social influence of parents and friends[J].J Pediatr (Rio J),2014,90(1):35-41.
[2] YEH C H,MAN W J,LIN U S,et al.A pilot study to examine the feasibility and effects of a home-based aerobic program on reducing fatigue in children with acute lymphoblastic leukemia[J].Cancer Nurs,2011,34(1):3-12.
[3] MULLER C,KRAUTH K A,GERSS J,et al.Physical activity and health-related quality of life in pediatric cancer patients following a 4-week inpatient rehabilitation program[J].Support Care Cancer,2016,24(9):3793-3802.
[4] SCHMITZ K H,COURNEYA K S,MATTHEWS C,et al.American College of Sports Medicine roundtable on exercise guidelines for cancer survivors[J].Med Sci Sports Exerc,2010,42(7):1409-1426.
[5] GOTTE M,KESTING S,WINTER C,et al.Comparison of self-reported physical activity in children and adolescents before and during cancer treatment[J].Pediatric Blood Cancer,2014,61(6):1023-1028.
[6] CHUNG O K,LI H C,CHIU S Y,et al.The impact of cancer and its treatment on physical activity levels and behavior in Hong Kong Chinese childhood cancer survivors[J].Cancer Nurs,2014,37(3):E43-E51.
[7] FUEMMELER B F,PENDZICH M K,CLARK K,et al.Diet,physical activity,and body composition changes during the first year of treatment for childhood acute leukemia and lymphoma[J].J Pediatr Hematol Oncol,2013,35(6):437-443.
[8] TAN S Y,POH B K,CHONG H X,et al.Physical activity of pediatric patients with acute leukemia undergoing induction or consolidation chemotherapy[J].Leuk Res,2013,37(1):14-20.
[9] 杨静.恶性肿瘤患儿住院期间体力活动状况及其影响因素的研究[D].广州:中山大学,2016.
[10]刘明.护理质性研究[M].北京:人民卫生出版社,2008:53-60.
[11]CHAN H Y,CHUI Y Y,CHAN C W,et al.Exploring the influence of Traditional Chinese Medicine on self-care among Chinese cancer patients[J].Eur J Oncol Nurs,2014,18(5):445-451.
[12]LANGEVELD N E,GROOTENHUIS M A,VOUTE P A,et al.Quality of life, self-esteem and worries in young adult survivors of childhood cancer[J].Psychooncology,2004,13(12):867-881.
[13]BANDURA A.Social foundation of thought and action:a social cognitive approach[M].Englewood Cliffs:Prentice-Hall,1986:5-10.
[14]KELLY A K.Physical activity prescription for childhood cancer survivors[J].Curr Sports Med Rep,2011,10(6):352-359.
[15]LAM K K,HO C W L,HO K Y,et al.Factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer:an exploratory study[J].J Clin Nurs,2017,26(1-2):190-201.
[16]孙艳玲,李苗,武万水,等.白血病儿童气质特征的探讨[J].中国实用儿科杂志,2007(11):860-861.
[17]MENDOZA J A,BAKER K S,MORENO M A,et al.A fitbit and facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors:a pilot study[J].Pediatric Blood Cancer,2017,64(12):9.
[18]CHENG L A,MENDONCA G,FARIAS J J.Physical activity in adolescents:analysis of the social influence of parents and friends[J].J Pediatr (Rio J),2014,90(1):35-41.