骨肉瘤患者照顾者创伤后成长体验的现象学研究
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摘要
目的探讨骨肉瘤患者照顾者创伤后成长的过程和体验。方法采用质性研究中的现象学研究方法,于2017年3—6月对上海交通大学医学院附属瑞金医院10名骨肉瘤患者照顾者进行半结构式访谈收集资料,按照Colaizzi内容分析法对资料予以整理分析。结果析出创伤反应和成长体验两大主题,其中创伤反应包括认知系统紊乱、负性情绪侵扰、社会行为退缩3个亚主题,成长体验包括感悟人生苦乐、获益各方关系、应对积极有效3个亚主题。结论骨肉瘤患者照顾者感知创伤产生负面情绪的同时也存在创伤后成长的积极表现,医护人员需关注照顾者的身心需求,帮助其构建积极有效的社会支持系统,激发其潜能,使其产生更多积极的效应,以期提高对患者的照顾质量。
Objective To explore the experiences of posttraumatic growth( PTG) in the caregivers of patients with osteosarcoma. Methods From March to June 2017,using the phenomenological method in qualitative study,the data of 10 caregivers of osteosarcoma patients in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were collected by semi-structured interview,sorted and analyzed according to Colaizzi content analysis. Results There were two aspects extracted: Traumatic reaction and posttraumatic growth experience. Traumatic reaction included cognitive conflict,moodiness and social withdrawal. Posttraumatic growth experience included bittersweet,improvement in relationship and positive coping strategy. Conclusion The caregivers of osteosarcoma patients would experience a range of difficult emotions throughout the cancer trajectory as well as remarkable changes in their lives,including positive and negative changes. The medical staff should give them professional care education and psychological nursing,help them to build social support system actively,so as to improve the quality of nursing care.
Objective To explore the experiences of posttraumatic growth( PTG) in the caregivers of patients with osteosarcoma. Methods From March to June 2017,using the phenomenological method in qualitative study,the data of 10 caregivers of osteosarcoma patients in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were collected by semi-structured interview,sorted and analyzed according to Colaizzi content analysis. Results There were two aspects extracted: Traumatic reaction and posttraumatic growth experience. Traumatic reaction included cognitive conflict,moodiness and social withdrawal. Posttraumatic growth experience included bittersweet,improvement in relationship and positive coping strategy. Conclusion The caregivers of osteosarcoma patients would experience a range of difficult emotions throughout the cancer trajectory as well as remarkable changes in their lives,including positive and negative changes. The medical staff should give them professional care education and psychological nursing,help them to build social support system actively,so as to improve the quality of nursing care.
引文
[1]杨湘越.骨肉瘤实验室诊断研究现状及对策[J/CD].中华临床医师杂志(电子版),2012,6(21):6841-6842.
[2]Mirabello L,Troisi RJ,Savage SA.Osteosarcoma incidence and survival rates from 1973 to 2004:data from the Surveillance,Epidemiology,and End Results Program[J].Cancer,2009,115(7):1531-1543.
[3]牛晓辉,徐海荣.骨肉瘤的化疗[J].中国癌症杂志,2010,20(2):81-85.
[4]张清,徐万鹏,郭卫,等.我国骨肉瘤治疗现状及改进建议-17家骨肿瘤治疗中心1998~2008年资料分析[J].中国骨肿瘤骨病,2009,8(3):129-132.
[5]Yonemoto T,Kamibeppu K,Ishii T,et al.Posttraumatic stress symptom(PTSS)and posttraumatic growth(PTG)in parents of childhood,adolescent and young adult patients with high-grade osteosarcoma[J].Int J Clin Oncol,2012,17(3):272-275.
[6]刘媛,胡爱玲,张美芬.骨肉瘤病人父母照护体验的质性研究[J].护理研究,2013,27(10B):3231-3233.
[7]张淑彬,吴朝平.骨肉瘤患者父母的焦虑状况调查分析[J].华西医学,2008,23(6):1435-1436.
[8]郝桂华,阮洪,杨志英.恶性骨肿瘤患儿直接照顾者照顾感受的质性研究[J].解放军护理杂志,2015,32(16):20-23.
[9]巩树梅,王怡沁,孙颖,等.喉软化症患儿父母创伤后成长体验的质性研究[J].解放军护理杂志,2016,33(20):12-15,35.
[10]谷艳霞,王遐.脑瘫患儿父母创伤后成长及影响因素[J].中国健康心理学杂志,2016,24(5):667-671.
[11]Gale NK,Heath G,Cameron E,et al.Using the framework method for the analysis of qualitative data in multi-disciplinary health research[J/OL].BMC Med Res Methodol,2013,13:117[2013-09-18].https://doi.org/10.1186/1471-2288-13-117.
[12]郑亚萍,楼妍.骨肉瘤照顾者压力测定及影响因素分析[J].中国实用护理杂志,2010,26(11):31-34.
[13]Gardner MH,Mrug S,Schwebel DC,et al.Benefit finding and quality of life in caregivers of childhood cancer survivors:the moderating roles of demographic and psychosocial factors[J].Cancer Nurs,2017,40(5):E28-E37.
[14]杜港,赵岳,夏利,等.癌症患儿父母心理健康状况及需求的调查研究[J].护理研究,2010,24(4A):871-872.
[15]李红,马保安,周勇,等.骨肉瘤患者家属心理反应及需求的调查研究[J].现代肿瘤医学,2008,16(1):114-116.
[16]Calhoun LG,Cann A,Tedeschi RG,et al.Traumatic events and generational differences in assumptions about a just world[J].JSoc Psychol,1998,138(6):789-791.
[17]Affleck G,Tennen H,Gershman K.Cognitive adaptations to highrisk infants:the search for mastery,meaning,and protection from future harm[J].Am J Ment Defic,1985,89(6):653-656.
[18]Picoraro JA,Womer JW,Kazak AE,et al.Posttraumatic growth in parents and pediatric patients[J].J Palliat Med,2014,17(2):209-218.
[19]Hullmann SE,Fedele DA,Molzon ES,et al.Posttraumatic growth and hope in parents of children with cancer[J].J Psychosoc Oncol,2014,32(6):696-707.
[20]栾贝贝,王维利,朱宇.癌症患者主要照顾者创伤后成长与应对方式、自我效能感的关系研究[J].中国全科医学,2016,19(19):2339-2343.
[21]陆朋玮.风湿性疾病患儿父母创伤后成长现状及其影响因素的研究[D].北京:北京协和医学院,2016.
[22]Hallam W,Morris R.Post-traumatic growth in stroke carers:a comparison of theories[J].Br J Health Psychol,2014,19(3):619-635.
[23]Senol-Durak E,Ayvasik HB.Factors associated with posttraumatic growth among myocardial infarction patients:perceived social support,perception of the event and coping[J].J Clin Psychol Med Settings,2010,17(2):150-158.
[24]孙琼,胡慧.老年痴呆患者照顾者创伤后成长的质性研究[J].现代临床护理,2015,14(8):42-46.
[25]崔粼,郭放,刘学华,等.恶性肿瘤患儿父母创伤后成长状况及影响因素分析[J].护理研究,2016,30(7C):2596-2599.
[26]金奕,刘燕.103例颅脑损伤患者创伤后成长状况及相关因素研究[J].天津护理,2012,20(3):127-128.
[27]Forinder U,Norberg AL.Posttraumatic growth and support among parents whose children have survived stem cell transplantation[J].J Child Health Care,2014,18(4):326-335.
[2]Mirabello L,Troisi RJ,Savage SA.Osteosarcoma incidence and survival rates from 1973 to 2004:data from the Surveillance,Epidemiology,and End Results Program[J].Cancer,2009,115(7):1531-1543.
[3]牛晓辉,徐海荣.骨肉瘤的化疗[J].中国癌症杂志,2010,20(2):81-85.
[4]张清,徐万鹏,郭卫,等.我国骨肉瘤治疗现状及改进建议-17家骨肿瘤治疗中心1998~2008年资料分析[J].中国骨肿瘤骨病,2009,8(3):129-132.
[5]Yonemoto T,Kamibeppu K,Ishii T,et al.Posttraumatic stress symptom(PTSS)and posttraumatic growth(PTG)in parents of childhood,adolescent and young adult patients with high-grade osteosarcoma[J].Int J Clin Oncol,2012,17(3):272-275.
[6]刘媛,胡爱玲,张美芬.骨肉瘤病人父母照护体验的质性研究[J].护理研究,2013,27(10B):3231-3233.
[7]张淑彬,吴朝平.骨肉瘤患者父母的焦虑状况调查分析[J].华西医学,2008,23(6):1435-1436.
[8]郝桂华,阮洪,杨志英.恶性骨肿瘤患儿直接照顾者照顾感受的质性研究[J].解放军护理杂志,2015,32(16):20-23.
[9]巩树梅,王怡沁,孙颖,等.喉软化症患儿父母创伤后成长体验的质性研究[J].解放军护理杂志,2016,33(20):12-15,35.
[10]谷艳霞,王遐.脑瘫患儿父母创伤后成长及影响因素[J].中国健康心理学杂志,2016,24(5):667-671.
[11]Gale NK,Heath G,Cameron E,et al.Using the framework method for the analysis of qualitative data in multi-disciplinary health research[J/OL].BMC Med Res Methodol,2013,13:117[2013-09-18].https://doi.org/10.1186/1471-2288-13-117.
[12]郑亚萍,楼妍.骨肉瘤照顾者压力测定及影响因素分析[J].中国实用护理杂志,2010,26(11):31-34.
[13]Gardner MH,Mrug S,Schwebel DC,et al.Benefit finding and quality of life in caregivers of childhood cancer survivors:the moderating roles of demographic and psychosocial factors[J].Cancer Nurs,2017,40(5):E28-E37.
[14]杜港,赵岳,夏利,等.癌症患儿父母心理健康状况及需求的调查研究[J].护理研究,2010,24(4A):871-872.
[15]李红,马保安,周勇,等.骨肉瘤患者家属心理反应及需求的调查研究[J].现代肿瘤医学,2008,16(1):114-116.
[16]Calhoun LG,Cann A,Tedeschi RG,et al.Traumatic events and generational differences in assumptions about a just world[J].JSoc Psychol,1998,138(6):789-791.
[17]Affleck G,Tennen H,Gershman K.Cognitive adaptations to highrisk infants:the search for mastery,meaning,and protection from future harm[J].Am J Ment Defic,1985,89(6):653-656.
[18]Picoraro JA,Womer JW,Kazak AE,et al.Posttraumatic growth in parents and pediatric patients[J].J Palliat Med,2014,17(2):209-218.
[19]Hullmann SE,Fedele DA,Molzon ES,et al.Posttraumatic growth and hope in parents of children with cancer[J].J Psychosoc Oncol,2014,32(6):696-707.
[20]栾贝贝,王维利,朱宇.癌症患者主要照顾者创伤后成长与应对方式、自我效能感的关系研究[J].中国全科医学,2016,19(19):2339-2343.
[21]陆朋玮.风湿性疾病患儿父母创伤后成长现状及其影响因素的研究[D].北京:北京协和医学院,2016.
[22]Hallam W,Morris R.Post-traumatic growth in stroke carers:a comparison of theories[J].Br J Health Psychol,2014,19(3):619-635.
[23]Senol-Durak E,Ayvasik HB.Factors associated with posttraumatic growth among myocardial infarction patients:perceived social support,perception of the event and coping[J].J Clin Psychol Med Settings,2010,17(2):150-158.
[24]孙琼,胡慧.老年痴呆患者照顾者创伤后成长的质性研究[J].现代临床护理,2015,14(8):42-46.
[25]崔粼,郭放,刘学华,等.恶性肿瘤患儿父母创伤后成长状况及影响因素分析[J].护理研究,2016,30(7C):2596-2599.
[26]金奕,刘燕.103例颅脑损伤患者创伤后成长状况及相关因素研究[J].天津护理,2012,20(3):127-128.
[27]Forinder U,Norberg AL.Posttraumatic growth and support among parents whose children have survived stem cell transplantation[J].J Child Health Care,2014,18(4):326-335.