互捐造血干细胞兄妹真实心理体验的质性研究
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摘要
目的探讨互捐造血干细胞兄妹真实心理体验,为临床实施针对性护理提供参考。方法采用质性研究中的现象学方法,对造血干细胞互捐兄妹进行面对面半结构式深入访谈,根据Colaizzi 7步分析法对资料进行整理分析,深入了解具有双重身份的互捐兄妹对于捐献的真实心理感受。结果从供者视角、受者视角以及家庭关系视角,共提炼出5个主题:歉疚,责任,担忧,亲情纽带,施恩与报恩。结论互捐兄妹多重心理体验并存,主要包括个体层面的歉疚、责任、担忧和家庭层面的亲情纽带、施恩与报恩。提示护理人员应重视供受双方的心理体验,充分利用家庭支持系统对移植患者的影响,积极做好心理干预,减轻其负性心理体验,促进患者疾病康复,提高患者生命质量。
Objective To look into the feelings of siblings donating hematopoietic stem cells and provide reliable theoretical basis for clinical psychological nursing. Methods A qualitative phenomenological research method was applied and semi-structured in-depth interviews were conducted in a brother and sister who donated hematopoietic stem cells to each other in separate cases over a span of eight years. The original data were analyzed based on Colaizzi 7 steps. Result Five themes were identified from the perspectives of donor, recipient and family relationships: guilty, responsibility, worry, family ties, obliging and gratitude. Conclusions Both brother and sister had various, complicated perceptions and experience including both individual level and social aspect. Nurses should understand feelings and psychological needs of both patients and donors, paying attention to their feelings and helping them cope with the mental problems. In the meanwhile, it is important to make the most of patients' family support systems so as to improve their quality of life.
Objective To look into the feelings of siblings donating hematopoietic stem cells and provide reliable theoretical basis for clinical psychological nursing. Methods A qualitative phenomenological research method was applied and semi-structured in-depth interviews were conducted in a brother and sister who donated hematopoietic stem cells to each other in separate cases over a span of eight years. The original data were analyzed based on Colaizzi 7 steps. Result Five themes were identified from the perspectives of donor, recipient and family relationships: guilty, responsibility, worry, family ties, obliging and gratitude. Conclusions Both brother and sister had various, complicated perceptions and experience including both individual level and social aspect. Nurses should understand feelings and psychological needs of both patients and donors, paying attention to their feelings and helping them cope with the mental problems. In the meanwhile, it is important to make the most of patients' family support systems so as to improve their quality of life.
引文
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[14]雷艳,汤红玲,傅碧玲,等.家庭亲密度和适应性对维持性腹膜透析患者生活质量的影响[J].护理学杂志,2013,28(15):18-19.
[15]NORBERG A L,BOMAN K K. Parents’ perceptions of support when a child has cancer:a longitudinal perspective[J].Cancer Nurs,2007,30(4):294-301.
[16]刘嘉,骆峻,曾庆琪.恶性肿瘤患者心理因素与社会支持的研究进展[J].中国肿瘤外科杂志,2017,9(5):331-333.
[17]LEKKA D,PACHI A,TSELEBIS A,et al. Pain and anxiety versus sense of family support in lung cancer patients[J].Pain Res Treat,2014,2014:312941.
[2]江玉军,张静.护理学位论文现象学研究方法中访谈提纲设计方法的内容分析[J].解放军护理杂志,2016,33(24):32-35.
[3]HUTT D,NEHARI M,MUNITZ-SHENKAR D, et al.Hematopoietic stem cell donation:psychological perspectives of pediatric sibling donors and their parents[J].Bone Marrow Transplantation,2015,50(10):1337-1342.
[4]李铮,刘宇.护理学研究方法[M].2版.北京:人民卫生出版社,2018:286.
[5]KISCH A M,FORSBERG A. The core of sibling stem cell donation——a grounded theory study[J].Open Nurs J,2017,11:73-83.
[6]KISCH A,BOLMSJO I,LENHOFF S. Being a haematopoietic stem cell donor for a sick sibling:adult donors’ experiences prior to donation[J].Eur J Oncol Nurs,2015,19(5):529-535.
[7]FEHR R,FULMER A,AWTREY E,et al.The grateful workplace:a multilevel model of gratitude in organizations[J].Academy of Management Review,2016,42(2):361-381.
[8]GRANT AM,GINO F.A little thanks goes a long way:explaining why gratitude expressions motivate prosocial behavior[J].J Pers Soc Psychol,2010,98(6):946-955.
[9]杨建英.感恩文化的理性思考[J].中华文化论坛,2014(7):183-187.
[10]SOUTHWICK S M,CHARNEY D S. The science of resilience:implications for the prevention and treatment of depression[J].Science,2012,338(6103):79-82.
[11]吴小婷,章新琼,王秋萍,等.癌症患者心理弹性干预的研究进展[J].中华护理杂志, 2017,52(3):316-320.
[12]SIMPSON G,JONES K. How important is resilience among family members supporting relatives with traumatic brain injury or spinal cord injury?[J]. Clin Rehabil, 2013,27(4):367-377.
[13]刘莉莉,林平,赵振娟.自我效能、社会支持及应对方式对急性心肌梗死患者心理弹性影响的路径分析[J].中华护理杂志,2016,51(1):21-25.
[14]雷艳,汤红玲,傅碧玲,等.家庭亲密度和适应性对维持性腹膜透析患者生活质量的影响[J].护理学杂志,2013,28(15):18-19.
[15]NORBERG A L,BOMAN K K. Parents’ perceptions of support when a child has cancer:a longitudinal perspective[J].Cancer Nurs,2007,30(4):294-301.
[16]刘嘉,骆峻,曾庆琪.恶性肿瘤患者心理因素与社会支持的研究进展[J].中国肿瘤外科杂志,2017,9(5):331-333.
[17]LEKKA D,PACHI A,TSELEBIS A,et al. Pain and anxiety versus sense of family support in lung cancer patients[J].Pain Res Treat,2014,2014:312941.