子宫内膜癌治疗后外阴淋巴水肿患者症状体验与心理感受的质性研究

目的 了解子宫内膜癌治疗后外阴淋巴水肿患者症状体验与心理感受,为医护人员加强重视与综合管理、促进患者身心康复提供参考。方法 采用目的抽样方法,于2020年8月—2021年1月对湖南省某三级甲等肿瘤医院淋巴水肿康复门诊就诊的16例子宫内膜癌治疗后外阴淋巴水肿患者进行半结构式深入访谈,根据Colaizzi 7步分析法进行分析并提炼主题。结果 归纳出4个主题,身体层面：肿胀不适感、下肢活动受限、排尿功能障碍;心理层面：病耻感、负性情绪与担忧预后、回避心理;家庭层面：夫妻亲热及性生活困扰、家庭负担增加;社会层面：工作回归改变、社会活动改变、期待社会支持。结论 子宫内膜癌治疗后外阴淋巴水肿患者面临诸多困扰,医护人员应完善症状管理,改善患者的身体不适,有效疏导情绪,减轻其心理压力;对家庭与社会层面的困难予以正确的指导与支持,以促进患者身心康复,提高生活质量。

Symptom Experience and Psychology of Patients with Genital Lymphedema after Treatment for Endometrial Cancer: A Qualitative Research

Objective To understand the symptom experience and psychology of patients with genital lymphedema after treatment for endometrial cancer, and to provide reference for the management and physical and psychological recovery of the patients. Methods With purposive sampling, 16 patients with genital lymphedema after treatment for endometrial cancer from a tertiary grade-A cancer hospital in Changsha from August 2020 to January 2021 were selected for semi-structured interviews, and the data were analyzed by Colaizzi 7-step analysis method. Results Four themes at different levels were extracted: body level including swelling, limited mobility of lower extremity, and trouble with urination; psychological level including stigma, negative emotions, worry about prognosis and avoidance; family level including trouble with sexual function, and increased family burden; social level including change in the job and social activities and expectation for social support. Conclusion Patients with genital lymphedema after treatment for endometrial cancer encounter much trouble. Symptom management to alleviate discomfort, psychological guidance to relieve stress, and support and guidance targeted for difficulties at the family and social level are conducive to promoting physical and psychological recovery of the patients, thus to improve the quality of life.