新确诊头颈肿瘤患者治疗前支持性照护需求现状及其影响因素研究

目的：探究新确诊头颈肿瘤患者治疗前支持性照护需求现状并分析影响因素,为制定相关照护方案提供依据。方法：采用一般资料问卷、癌症患者支持性照护需求量表（SCNS-SF34）、安德森头颈症状调查表（MDASI-H&N）、社会支持量表（SSRS）及医院焦虑抑郁量表（HADS）对184例头颈肿瘤患者进行调查。结果：支持性照护需求得分前3位的维度为生理和日常生活需求（2.95±0.75）分、医疗服务与信息需求（2.92±0.46）分、心理需求（2.64±0.65）分。多元线性回归分析显示,职业、疾病部位、治疗方式、社会支持、焦虑、症状负担是支持性照护各维度需求的影响因素（P<0.05）。结论：新确诊头颈肿瘤患者治疗前生理和日常生活需求、医疗服务与信息需求、心理需求较高。医护人员应重点依据职业、疾病部位、治疗方式、社会支持、焦虑、症状负担状况制定并调整支持性照护方案,以提高患者支持性照护需求满足度。     

宫颈癌根治术后患者不同时期支持性照顾需求的现象学研究

目的 ：探讨宫颈癌根治术后患者不同时期支持性照顾需求,为开展以需求为导向的护理服务提供依据。方法 ：采用目的抽样法,选取2021年5月—11月在济南市某三级甲等医院行宫颈癌根治术的16名住院患者为研究对象,分别于术后7日（调整期）、术后3个月（适应期）和术后6个月（稳定期）进行3次半结构式访谈,采用Colaizzi 7步分析法整理分析资料,应用支持性照顾需求多维模型进行归类。结果 ：共提炼出5个主题,分别为不适症状及渴望恢复日常生活、消极心理感受、多方面支持与延续医疗服务需求、信息支持不足、性需求。结论：宫颈癌根治术后患者支持性照顾需求随病程变化而有不同特点,医护人员需要采用动态连续的观念,科学评估患者的需求,继而实施精准护理服务,提高患者疾病认知及应对能力。     

卵巢癌患者支持性照护需求的质性研究

目的 深入了解卵巢癌患者在诊疗和康复阶段的支持性照护需求,为制定全程的支持性照护服务方案提供依据。方法 采用描述性质性研究方法,应用最大差异抽样法,选取2021年11月—2022年3月上海某三级甲等妇产科医院的18名卵巢癌患者进行个人半结构式深入访谈,运用内容分析法对访谈资料进行整理分析。结果 卵巢癌患者支持性照护需求可归纳为5个主题,即信息需求：了解疾病常规诊疗信息与诊疗前沿信息、获取早期康复指导信息;社会支持需求：家庭支持、同伴支持、延续性专业照护支持;生理需求：改善疾病躯体症状需求、缓解疾病特异性症状负担;心理需求：专业心理咨询、维护尊严需求、遗传风险担忧;实际需求：子女照护需求、经济需求。结论 卵巢癌患者在整个疾病过程中面临多维度的支持性照护需求,医护人员通过动态评估和管理,构建基于需求的支持性照护方案,优化卵巢癌患者管理模式,以期改善患者健康结局。     

宫颈癌患者支持性照顾需求的调查

目的调查宫颈癌患者治疗期间支持性照顾需求及影响因素。方法采用癌症患者支持性照顾需求调查问卷对正在接受治疗的200例宫颈癌患者进行调查。结果宫颈癌患者支持性照顾需求各维度得分由高到低依次是心理需求、健康信息需求、支持和照顾需求、生理和日常生活需求、性需求。年龄、民族、是否知晓诊断、文化程度和发病情况是宫颈癌患者支持性照顾需求的影响因素(P0.01)。结论医护人员在临床工作中要注意宫颈癌患者文化程度、年龄和民族等差异,重视患者的需求,为患者提供针对性护理服务。     

晚期卵巢癌患者接受CAR-T临床试验真实体验的质性研究

目的 描述接受嵌合抗原受体Ｔ 细胞（ CAR-T）治疗的晚期卵巢癌患者的真实体验，为采取有针对性的护理干预提供参考依据。方法 采用描述性现象学研究方法，选取2021年1月至9月在本中心接受CAR-T 治疗的晚期卵巢癌患者8名进行半结构式深入访谈，并采用Colaizzi 分析程序进行对资料的分析、整理、提炼主题。结果 按不同时期包括等待入组期、单核细胞采集期、细胞回输期、随访期，主题可归纳为①正性和负性情绪的交织（幸运、无助、兴奋、恐惧等）；②社会支持性需求；③渴望自我管理。结论 接受CAR-T临床试验的晚期卵巢癌患者的心理、生理及社会支持均应得到医护人员和家庭的密切关注。规范化的管理和针对性的知识宣讲能加快患者康复和提高其满意度。     

食管癌术后患者及家属居家支持性照护需求质性研究的Meta整合

目的 系统评价食管癌术后患者及家属居家支持性照护需求的质性研究,为食管癌术后患者开展优质延续性护理提供依据。方法 计算机检索PubMed、Cochrane Library、Web of Science、Embase、CINAHL、Psych-INFO、中国知网、中国生物医学文献数据库、万方数据知识服务平台、维普资讯中文期刊服务平台等有关食管癌患者及家属居家支持性照护需求的质性研究,检索时限为建库至2022年3月。使用JBI循证卫生保健中心质性研究质量评价标准进行评价,采用汇集性整合方法进行整合分析。结果 共纳入7篇中英文文献,提炼出23个研究结果,归纳出10个新类别,整合成4个整合结果：生理支持需求、信息支持需求、心理支持需求及社会支持需求。结论 食管癌术后患者及家属居家支持性照护需求具有特殊性、复杂性及多样性的特点。医护人员应高度重视食管癌术后患者及家属居家支持性照护需求,根据患者及家属具体需求制定支持性护理计划、完善术后随访体系、提供多样化的延续护理模式,提高患者术后生存质量。     

肝癌生存者支持性照顾需求和心理韧性的相关性研究

目的：调查肝癌生存者支持性照顾需求现状及心理韧性,并探讨两者间的相关性,为提高肝癌生存者照顾质量提供依据。方法：采用便利抽样法,选取120例肝癌生存者,采用自制一般资料调查表、支持性照顾需求量表（SCNS-SF34）和心理韧性量表进行问卷调查。结果：肝癌生存者支持性照顾需求总分为69.00（57.00,90.50）,其中健康信息需求得分最高24.00（17.50,32.50）;心理韧性总分为28.00（21.00,34.00）。心理韧性与支持性照顾需求成负相关（r=-0.314,P=0.001) 。结论：肝癌生存者存在不同程度的支持性照顾需求,心理韧性较差的肝癌生存者支持性照顾需求较高,提示医护人员可以通过加强对肝癌生存者支持性照顾需要的护理干预,以改善他们的心理韧性水平。     

结直肠癌幸存者支持性照护和社会适应性相关性研究

目的 调查结直肠癌幸存者支持性照护、社会适应性现状并探索两者的相关性。方法 便利抽样法选取2022年1月—7月山东省某三级甲等医院的结直肠癌幸存者147名,采用问卷调查法收集患者一般资料、癌症幸存者未满足的需求量表、社会适应性量表进行调查。结果 结直肠癌幸存者癌症幸存者未满足的需求量表总分为(116.37±37.21)分,其各维度得分分别为：信息与医疗(29.63±9.40)分、生活愿景(25.08±8.44)分、人际关系(24.41±8.67)分、综合支持(23.98±8.56)分、生活质量(13.57±4.95)分;结直肠癌幸存者社会适应性量表总分为(89.02±16.22)分,其各维度得分分别为：重整规划(32.80±6.40)分、重建效能(33.96±6.31)分、专注康复(18.53±3.74)分;患者癌症幸存者未满足的需求量表总分及各维度得分与社会适应性量表总分呈负相关。结论 在临床工作中,临床医护人员要了解结直肠癌幸存者各个阶段的支持性照护需求,满足其需求,促进其重返社会。     

恶性血液病患者支持性照顾需求与焦虑抑郁相关性研究

目的：了解恶性血液病患者支持性照顾需求状况与焦虑抑郁相关性,为临床护理工作者有效地开展优质护理服务工作,采取针对性干预措施提供依据。方法：采取便利抽样方法对2017年10月—2018年10月在我院住院接受治疗的130份病例,应用一般资料调查表、支持性照顾需求量表、医院焦虑抑郁量表进行问卷调查。结果: 恶性血液病患者在支持性照顾需求中各维度均存在未满足状况,其中在健康信息需求、心理需求方面未满足程度最高,性需求最低。焦虑、抑郁与支持性照顾需求各维度及总需求除性需求外,都呈显著正相关(P＜0.05)。结论：恶性血液病患者支持性照顾需求各维度均存在未满足状况,除性需求外与焦虑抑郁均具有显著相关性,临床护理人员应加强健康教育的有效落实,关注患者情绪变化及时做好心理支持,有针对性提供相应帮助,满足患者需求,提高生活质量。     

结肠癌、直肠癌病人术后支持性照顾需求差异研究

目的：比较结直肠癌病人术后支持性照顾需求的不同,为护理人员开展健康指导提供依据和指导。方法：选择2012年37月在某三级甲等肿瘤专科医院通过病理检查确诊的结直肠癌接受手术的161例病人,在癌症病人支持性照顾需求调查问卷（SCNS）的基础上,设计增加未保肛病人适用的造口支持需求维度进行问卷调查,共6个维度70个条目。结果：结肠癌和直肠癌病人术后心理需求和照顾与支持需求无差异,健康信息需求、生理及日常生活需求、性需求、造口需求有统计学差异（P〈0．05）。有无造口病人的健康信息需求、造口需求有统计学差异（P〈0．05）。结论：直肠癌病人术后支持性照顾需求高,应给予更多重视和指导,医务人员是结直肠癌病人最需要的社会支持力量,应利用这种信赖关系给予系统的健康指导,帮助病人实现生理-心理-社会的全面康复,提高生活质量,早日重返社会。     

Exploring the Unmet Supportive Care Needs of Breast Cancer Survivors Experiencing Psychological Distress: Qualitative Study

ObjectivesThis study aimed to explore the unmet supportive care needs of breast cancer survivors who experience psychological distress.Data SourcesA qualitative study design with inductive content analysis was used. Semistructured interviews were conducted with 18 Turkish breast cancer survivors who experienced psychological distress. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the study.ConclusionThree key themes emerged from data analysis: sources of psychological distress, unmet supportive care needs, and barriers to support. The survivors who experienced psychological distress defined a variety of unmet supportive care needs, in the areas of information support, psychological/emotional support, social support, and individualized health care support. They also described personal and health professional−related factors as barriers.Implications for Nursing PracticeNurses should assess psychosocial well-being and supportive care needs of breast cancer survivors. Survivors should be supported to discuss their experiences of symptoms in the early survival phase, and they should be referred to an appropriate supportive care resource. A multidisciplinary survivorship services model is needed to offer posttreatment psychological support routinely in Turkey. Early, effective psychological care integrated into follow-up services for survivors can be protective against psychological morbidity.     

Transitioning to survivorship: a pilot study.

There are no clear transition guidelines for adolescent and young adult cancer patients, their parents, and their primary care providers (PCPs) when completing active therapy and within the first few years after therapy. The purpose of this pilot study was to identify needs and concerns of recently treated adolescent cancer patients and their parents, young adult cancer survivors, and the community PCPs of adolescent patients. Four focus group interviews were conducted with survivors and parents, and 3 in-depth interviews were conducted with PCPs. All interviews were audiotaped and transcribed for content analysis. A range of needs were identified, including lack of adequate written and verbal information about their prior treatment, its potential side effects, and appropriate follow-up care. The best sources for education were identified as the primary oncologist, nurse practitioner, or nurse. At completion of treatment, parents and adult survivors felt a lack of psychosocial support. Suggestions from participants included use of informational videos for survivors, weekend education and support programs, ongoing support groups, use of the Internet, and educational newsletters. The PCPs reported a lack of general pediatric oncology knowledge and specific patient information, time constraints in their patient schedules, and having few survivors in their practices as barriers to optimal survivorship care. Further research is needed to look at the unmet educational and psychological needs of childhood cancer survivors and their parents during the critical time when they transition off treatment.     

癌症患者社会疏离体验的质性研究

目的 描述癌症患者社会疏离的体验,旨在为该人群护理支持方案的制订提供参考依据。方法 采用描述性质性研究,按照目的抽样法,于2021年11月—12月选取在上海市某三级甲等肿瘤医院复诊治疗的20例癌症患者进行半结构式深入访谈,并以内容分析法归纳和提炼主题。结果 将癌症患者社会疏离的体验提炼为3个主题：社交退缩（癌因性症状的困扰、健康受损的忧虑、病耻感的影响、社交兴趣缺乏）;隐匿心声（自我忍受痛苦、担心影响他人、沟通交流不畅）;渴望支持（依赖家庭支持、感恩朋友支持、亟需专业支持）。结论癌症患者由于生理健康受损、心理状况不良、社会支持不足等存在社会疏离,医护人员应加强对该人群的症状管理和心理疏导,强化家庭及社会支持,以帮助其重返和适应社会。     

Healthcare and support needs of women with suspected breast cancer

AIM: This paper is a report of a study to investigate changes in the healthcare and support needs during the diagnostic period, and factors that affect these needs in women with suspected breast cancer. BACKGROUND: Although the needs of women with breast cancer are well recognized, few studies have examined the needs of women with suspected breast cancer during the diagnostic period. METHOD: This longitudinal study used an investigator-developed, self-administered questionnaire to collect data from 127 women in Taiwan on three occasions: notification of need for breast biopsy, before biopsy and after diagnosis. The data were collected from November 2004 to April 2005. FINDINGS: Participants had high need levels before and after diagnosis, with their top needs in the domains of healthcare services for diagnosis, follow-up and consultation, and information about the disease. They needed disease- and treatment-related information more than emotional support. Need levels were higher (P < 0.01) before diagnosis than after, highest before biopsy, and lowest after diagnosis. Furthermore, needs were higher (P < 0.01) before than after diagnosis for diagnostic services, disease information, and involvement of family and friends. Higher needs were found in married women with more education and no history of benign tumours. Need level did not differ statistically significantly by age, religious status, degree of social support, family history and breast symptoms. CONCLUSION: Need levels of women with suspected breast cancer vary during the diagnostic period, are highest before breast biopsy, and related to personal characteristics and cultural context. Therefore, during this period, nursing staff should provide patients and families with culturally sensitive, individualized, supportive care.     

Adolescent cancer survivors' experiences of supportive care needs: A qualitative content analysis

Supportive care is an important strategy that can help cancer survivors manage changes and problems during their follow‐up care. Identifying patients' care needs is one of the primary steps of the nursing process to plan effective nursing interventions. The aim of this study was to explore adolescent cancer survivors' supportive care needs. Purposeful sampling was adopted to select 49 participants from hospitals to participate in face‐to‐face, semistructured interviews. The qualitative content analysis method was conducted for data analysis. Ten subcategories and four main categories – empathetic care, information about survival period, instrumental support, and cooperation in care – were extracted from the data. These four categories formed a major theme, “supportive care”, as the primary healthcare need. This study highlights that supportive care should be developed collaboratively by family and healthcare providers to meet the needs of adolescent cancer survivors. Survivors' strengths and limitations should be identified, and then supportive care can be provided, such as giving appropriate information, enabling survivors to access supportive networks, and improving survivors’ confidence and autonomy with their self‐management.     

Perceptions of supportive communication in Chinese patients with cancer: experiences and expectations

AIM: This paper reports the findings of a study exploring the experiences and expectations of patients with cancer of supportive communication in the context of Chinese culture. BACKGROUND: Patients with cancer experience psychological distress, particularly in the initial period after diagnosis. Supportive communication can positively affect their psychological adjustment. Previous studies have reported the functions, contents, types and sources of informational support for patients with cancer in Western studies, but patients from different cultural backgrounds who have cancer might have different preferences in seeking support. METHODS: Semi-structured interviews were carried out with a convenience sample of 20 Chinese patients with cancer during 2002. Content analysis was used to identify themes within the data. FINDINGS: Chinese patients with cancer have a substantial need to receive informational and emotional support during the period of their hospitalization. Their support networks include doctors, nurses, family members, relatives and fellow patients. The expectations of support from different sources varied according to the nature of the relationship between patients with cancer and providers of support. Patients were active in seeking information and they perceived communication with doctors, nurses and fellow patients as beneficial. Most would only express emotional needs to their close family members and did not expect healthcare professionals to provide emotional support. However, interviewees perceived the caring behaviours of nurses and the emotional support of fellow patients as two important sources of support. CONCLUSION: For Chinese patients, coping with illness and misfortune is largely a private and family affair, and most of them did not expect nurses to meet their emotional needs. Nurses should be aware of the type, timing and source of supportive communication that Chinese patients find valuable. This will help them to provide the appropriate support to meet patients' needs.     

妇科恶性肿瘤患者支持性照顾需求的研究

目的 探讨妇科恶性肿瘤患者治疗期间支持性照顾需求未满足及需要帮助情况.方法 采用描述性研究设计,用癌症患者支持性照顾需求问卷(Supportive Care Needs Survey,SCNS)对正在接受治疗的100例妇科恶性肿瘤患者进行调查.结果 本组患者支持性照顾需求各维度平均未满足率分别为健康信息维度76.7%、性维度70.7%、心理维度55.2%、生理与日常生活维度48.5%、照顾与支持维度34.1%;患者上述维度需要帮助程度得分依次为(1.40±0.88)分、(1.38±0.71)分、(0.97±0.51)分、(1.01±0.64)分、(0.80±0.65)分.结论 妇科恶性肿瘤患者支持性照顾各方面均有未满足情况,其中健康信息、性方面需要帮助程度较高.患者期望医生传达与病情、治疗有关的决策和信息,期望护士扮演照顾者、指导者、支持者的角色;期望得到病友心理方面的支持与帮助.     

Breast cancer survivors’ supportive care needs 2–10 years after diagnosis

GOALS OF THE WORK: A significant proportion of breast cancer patients experience psychosocial morbidity after treatment, although their longer-term outcomes and supportive care service needs have not been comprehensively documented. The aim of this study was to identify longer-term outcomes and supportive care needs in disease-free breast cancer survivors. MATERIALS AND METHODS: One hundred seventeen patients who had been diagnosed with breast cancer 2-10 years earlier completed questionnaires to assess psychosocial outcomes including supportive care needs, psychological distress, and quality of life (QoL). MAIN RESULTS: QoL and depression scores were consistent with community rates although anxiety scores were higher. Approximately two thirds of survivors reported at least one unmet need, most frequently concerning existential survivorship issues, thereby highlighting the unique needs of survivors. Years since diagnosis was not correlated with need levels. Survivors classified as clinically anxious reported over three times as many unmet needs and survivors classified as depressed reported over two and a half times as many unmet needs. Positive outcomes were frequently reported. CONCLUSIONS: The findings have direct clinical relevance: irrespective of years since diagnosis, comprehensive and extended supportive care services are required to identify breast cancer survivors in need of supportive care interventions and remediate high levels of anxiety.