摘要
目的描述肺癌免疫治疗患者皮肤毒性反应的自我管理体验和现存问题。方法采用描述性质性研究,根据目的抽样法,于2023年2-4月选取我院胸部肿瘤内科的15例免疫治疗后发生皮肤毒性反应的肺癌患者进行面对面半结构式深入访谈,并采用内容分析法对资料进行归纳与整理。结果将肺癌免疫治疗患者皮肤毒性反应的自我管理体验共提炼为3个主题:多重消极影响(外在形象受损、睡眠质量降低、负性情绪困扰);患者应对方式(顺应症状自然发展、寻求专业支持、自我应对);自我管理现存问题(疾病信息支持不足、咨询平台缺乏、自我应对无效、心理问题仍待解决)。结论肺癌免疫治疗后发生皮肤毒性反应的患者症状负担涉及生理、心理及日常生活等多方面,患者在进行自我管理时仍面临较多阻碍和未满足的需求,医护人员应有针对性地给予患者自我管理指导,加强心理疏导与居家支持,帮助其提高自我管理能力,改善生活质量。
Objective To describe the self-management experience and existing problems of cutaneous toxic reactions in patients with lung cancer immunotherapy.Methods Based on descriptive qualitative research,a total of 15 patients with lung cancer who had skin toxic reaction after immunotherapy were selectedby the objective sampling methodfrom the thoracic oncology department of our hospital from February to April 2023 for face-to-face semi-structured in-depth interviews,and the data were summarized and sorted by content analysis method.Results The self-management experience of skin toxicity in lung cancer immunotherapy patients was divided into 3 themes:Multiple negative effects(impaired appearance,decreased sleep quality,and negative emotional distress);Patient coping style(natural progression of symptoms,seeking professional support,and self-coping);Existing problems of self-management(insufficient disease information support,lack of consultation platform,ineffective self-coping,and psychological problems still to be solved).Conclusion The symptom burden of patients with cutaneous toxic reactions after immunotherapy for lung cancer involves many aspects such as physiology,psychology,and daily life.Patients still face many obstacles and unmet needs in self-management.Medical staff should provide targeted self-management guidance to patients,strengthen psychological counseling and home support,help them improve their self-management ability,and improve their quality of life.
作者
张婷婷
陆箴琦
张晓菊
陈凤珍
ZHANG Tingting;LU Zhenqi;ZHANG Xiaoju;CHEN Fengzhen(Department of Nursing,Fudan University Shanghai Cancer Center/Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)
出处
《护士进修杂志》
2024年第14期1482-1487,共6页
Journal of Nurses Training
基金
国家自然科学基金青年科学基金项目(编号:72004031)。
关键词
肺癌
免疫治疗
皮肤毒性
症状体验
自我管理
质性研究
lung cancer
immunotherapy
skin toxicity
symptom experience
self-management
qualitative study
