成人癌症患者支持性照护需求的研究现状

<正>近年来,全球癌症的发病率呈现持续升高的总体趋势,预计到2030年全球将有7500万癌症患者,癌症已成为全球性的公共卫生问题[1]。随着癌症患者生存时间越来越长,长期反复的治疗给癌症患者带来巨大的身心痛苦,严重影响了患者的生活质量。系统了解癌症患者的需求情况,提供合适的心理社会支持与帮助,最大限度地满足患者的需求,使其积     

对337例癌症患者体检中的相关需求调查分析

目的 确定癌症病人的需要，探讨其需要帮助程度的影响因素。方法 对337例第1诊断为子宫癌、鼻咽癌、肺癌等的病人采用卡氏功能量表（KPs）和癌症病人需要调查问卷（SCNS）进行调查。结果 在调查的5个需要领域中，癌症病人对健康信息领域需要最多，需要帮助的程度也最高，其次是心理需要、生理与日常生活需要。病人的年龄、健康状态、诊断与治疗方式是影响癌症病人需要帮助程度的重要因素。结论 癌症病人的需要没有得到很好的满足，社会和医务人员对癌症病人的支持有必要进一步加强。     

胃癌患者支持性照顾需求的现状及其影响因素

目的探讨胃癌患者支持性照顾需求现状,分析其影响因素。方法2018年10月至2019年3月,采用便利抽样法选取在中山大学肿瘤防治中心和中山大学附属第六医院门诊和肿瘤科的178例胃癌患者为研究对象。采用一般情况调查问卷、支持性照顾需求简明问卷(the supportive care needs survey-34-item short form,SCNS-SF34)、安德森症状评估量表胃肠道肿瘤特异性模块(the M.D.Anderson symptom inventory gastrointestinal cancer module,MDASI-GI)及恐惧疾病进展简化量表(fear of progression questionnaire short form,FoP-Q-SF)对其进行调查。结果178例胃癌患者的总体SCNS-SF34得分为(2.87±0.59)分。不同文化程度、肿瘤部位、临床分期、白蛋白数值的胃癌患者SCNS-SF34总分差异均有统计学意义(均P<0.05)。症状严重程度、症状困扰程度得分与胃癌患者SCNS-SF34总分相关,相关系数为0.743、0.777;FoP-Q-SF总分及生理健康维度、社会家庭维度得分与胃癌患者的支持性照顾需求得分相关,相关系数分别为0.818、0.817、0.739。文化程度、症状体验和恐惧疾病进展心理是胃癌患者的支持性照顾需求的主要影响因素。结论胃癌患者支持性照顾需求的满足情况不理想,应通过评估患者症状体验、恐惧疾病进展水平来制定个性化的护理方案以满足患者需求。     

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。     

肠造口病人支持性照顾需求的研究进展

从支持性照顾需求概念及理论实质、评估工具、研究内容、支持性照护措施等方面综述国内外肠造口病人支持性照顾需求的研究进展。指出了解肠造口病人各个方面的需求状况很有必要,对国内外未来研究方向提出展望。     

肺癌患者术后癌症复发恐惧水平及其与心理韧性、支持性照顾需求的相关性

目的 了解肺癌患者术后癌症复发恐惧现状,探讨肺癌患者术后癌症复发恐惧水平与其心理韧性、支持性照顾需求的相关性。方法 采取便利取样法选取2018年2月—2021年2月本院收治的156例肺癌术后患者作为本次研究调查对象,采用一般资料调查表、癌症复发恐惧量表(FCRI-CV)、心理韧性量表(CD-RISC)、支持性照顾需求量表(SCNS-SF34)对患者进行调查。采用Pearson相关分析分析患者癌症复发恐惧与心理韧性、支持性照顾需求的相关性,采用多元线性回归分析影响肺癌患者术后癌症复发恐惧的相关因素。结果 本研究156例肺癌术后患者FCRI-CV平均总得分为(91.51±20.36)分,得分处于较高水平,其中轻度36例(占23.08%),中度94例(占60.26%),重度26例(占16.67%);心理韧性、支持性照顾需求总平均得分分别为(64.48±10.20)分、(87.70±25.36)分;经Pearson相关分析结果发现,肺癌术后患者癌症复发恐惧总分以及各维度得分与心理韧性总分呈负相关(P<0.05),与支持性照顾需求总分呈正相关(P<0.05)。单因素分析结果显示：不同...     

妇科恶性肿瘤患者不同治疗阶段支持性照顾需求的调查分析

目的了解不同治疗阶段妇科恶性肿瘤患者支持性照顾需求变化,为制订针对性干预策略提供依据。方法采用一般资料调查表和支持性照顾需求问卷对重庆市3所三级甲等医院的138例初诊妇科恶性肿瘤患者于确诊时、确诊后3个月、确诊后6个月进行跟踪调查。结果妇科恶性肿瘤患者支持性照顾需求各维度除生理与日常生活需求、心理需求维度外,各维度得分在确诊后3个月均呈下降趋势,照顾与支持需求及性需求维度在确诊后6个月出现回升趋势,各维度3个时间点差异均具有统计学意义(P0.01或P0.05)。结论妇科恶性肿瘤患者在疾病进展和治疗过程中支持性照顾需求呈现动态变化趋势,建议动态评估患者需求,做好每一阶段相关症状的预防和针对性护理工作。     

癌症患者照顾者需求评估工具的研究进展与展望

<正>癌症是严重威胁人类健康的重大疾病之一,其发病率在国内外均呈持续升高的总体趋势~([1-2])。受经济、卫生资源配置等多因素的限制,癌症患者的照护工作下放至各个家庭,患者的配偶、子女或父母成为主要照顾者,参与患者的疾病治疗、护理和康复等多重任务~([3-4])。鉴于照顾者自身情况、所承担的照护责任、家庭角色和社会角色的差异,照护过程中可能出现不同的生理、心理、社会支持需求。需求的评估有助于医护人员为照顾者提供精准干预,从而提高其身心健康和照护满意度,并进一步提高对癌症患者的照护质量~([5])。因此,本文对癌症患者照顾者需求评估工具进行综述,以期为国内学者选取适当需求评估工具、引进国外相关工具及构建适宜我国癌症患者照顾者的需求评估工具提供参考。     

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。     

Life after cancer: couples’ and partners’ psychological adjustment and supportive care needs

Goals of work Partners of cancer patients may experience significant distress at the time of treatment and many may experience persistent difficulties, although little research has examined their longer term psychosocial outcomes or supportive care needs. Materials and methods One hundred and fifty-four cancer survivors who were 1–11 years post diagnosis and disease-free and their partners completed mailed questionnaires. Main results A positive relationship was found between psychological distress and supportive care needs both within and between partner and survivor samples. Partners reported high levels of anxiety and supportive care needs, most frequently concerning relationships and the impact of the cancer illness. Partners within couples reported both shared and unique needs, although agreement on ratings of shared needs was low. Needs did not diminish over time although partners demonstrated psychological resilience and reported positive outcomes. Predictors of distress and unmet needs were explored: physical QOL, relationship satisfaction, and total needs contributed to variability in partners’ distress; relationship satisfaction and total needs were associated with survivors’ distress. Distress and relationship satisfaction were associated with partners’ unmet needs; only distress was associated with survivors’ unmet needs. Conclusions Partners are not merely providers of support, but need support themselves many years after a cancer diagnosis and in the context of apparently cured disease. The quality of the dyadic relationship may be critical in determining both partner and survivor distress and needs, and may prove a useful target for psychosocial interventions.     

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。     

胃肠道肿瘤患者支持性照顾需求的现状及影响因素分析

目的:调查胃肠道肿瘤患者支持性照顾需求现状,并探究其影响因素.方法:采用一般资料调查表、支持性照顾需求量表对120例胃肠道肿瘤患者进行调查.结果:胃肠道肿瘤患者的支持性照顾需求得分为(96.05±27.98)分,条目总均分为(2.90±0.82)分.多元线性回归分析显示,文化程度、家庭人均月收入及年龄是影响胃肠道肿瘤患...     

Perceived symptoms and the supportive care needs of breast cancer survivors six months to five years post-treatment period

PurposeThis study characterized the range and levels of perceived symptoms and unmet needs reported by breast cancer survivors in the half-year to five year post-treatment period, and determined whether the symptoms can be a predictor of unmet needs.MethodsIn a cross-sectional study, 150 breast cancer survivors (mean age: 55.1 ± 8 years) at the half-year to five year post-treatment period were enrolled for analysis. The measuring scales used included the Memorial Symptom Assessment Scale (MSAS), and the Supportive Care Needs Survey Short Form (SCNS-SF34).Results88% of the survivors reported having at least one symptom, while 51% reported at least one unmet need. Lack of energy was the most prevalent symptom (47%), followed by numbness/tingling in hands/feet (41%). Most of the survivors had unmet needs in the Health care system/Information domain (37% reported at least one unmet need for help), followed by Psychological needs (29%). The mean scores for the SCNS-SF34 domains, except for sexuality, were significantly higher in the high-symptom group (mean 17.6–32.2) compared with the low-symptom group (mean 3.5–22.3) (p < 0.01). Regression of the SCNS-SF34 domain scores against the MSAS scores revealed an increase in the explained variance of from 14% to 54%.ConclusionOur results suggest that breast cancer survivors continue to experience a multitude of symptoms, and the burden of symptoms may be associated with unmet needs across a range of domains.     

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.     

Creating a culture of compassion: developing supportive care for people with cancer

Receiving the 2003 Distinguished Merit Award from the European Oncology Nursing Society is a great moment in my professional career. It is also a time for reflection. We can easily become immersed in the specifics of our work and forget the larger picture. An opportunity such as this allows me to step back, reflect and review what I have accomplished. It also challenges me to think about the totality of cancer nursing and cancer care, look at where we have been and about where we should be going. At the heart of this lies the concept of supportive care. I would like to consider three pertinent areas. First, I will define what I consider the domain of supportive care in cancer to be. Second, I will look at what is needed to further supportive care for people with cancer. This involves building the discipline of more rigorous symptom assessment and documentation; better management of the symptoms and concerns that confront people with cancer; moving beyond the traditional framework of treatment and care, embracing a more integrated approach; addressing quality whilst at the same expediting the delivery of supportive care services. Third, I would like to consider the challenges to reform that this presents for cancer nursing and cancer nurses. A road map for change will be presented which highlights both the necessity to promote a supportive care culture whilst simultaneously building a dedicated infrastructure of staff and services. Nurses must play a key role in supportive care. Because of our unique clinical and research base, we are primed to assume leadership roles in both these spheres. Mutual valuing, partnership and shared working are the only means of delivering enhanced cancer care. We should grasp opportunities, confident that together we have the skills and knowledge to move forward. Today is yesterday's tomorrow. We cannot do anything about yesterday, but we can do something about today to ensure tomorrow is how we want it to be. We can become what we dream, let us live that dream outside and really drive forward the care we provide for people with cancer and their families.     

The Initial Health Assessment: an intervention to identify the supportive care needs of cancer patients

Background The first step in effective supportive care delivery is an assessment of patient needs. The Initial Health Assessment Form (IHA) was developed to aid clinicians in recognition and documentation of a patient's supportive care needs during their first visit to a comprehensive cancer centre. The purpose of this study was to determine the relative effectiveness of this instrument as compared to routine practice.Methods A before-after study was performed. Charts of consecutive patients with newly diagnosed cancer attending the Hamilton Regional Cancer Centre were selected randomly. Each chart was reviewed to determine the documentation at the initial patient assessment of 22 supportive care items under eight domains of need: physical, psychological, daily living, social, financial, informational, special needs and personal resources. The pre-intervention evaluation (T1) occurred over a 3-month period followed by the introduction of the IHA into clinical practice. Three months after its introduction, the post-intervention (T2) evaluation took place over the ensuing 3 months.Results A total of 306 charts were evaluated (153 each in T1 and T2). Patients from the two time periods were comparable with respect to background demographic variables. Introduction of the IHA increased the mean documentation of supportive care needs and resources from 26% in T1 to 49% in T2 (p=0.001). Significant improvements were found in all domains of need. Despite improvements, documentation of assessment continued to remain low for daily living, social, financial, and informational needs.Conclusions The IHA improved documentation of supportive care needs and resources. There is still room for improvement.Source of financial support: Ontario Ministry of Health and Long-Term Care, Health Systems Linked Research Unit Grant.     

结直肠癌患者术后支持性照顾需求调查研究

目的：全面了解结直肠癌患者术后支持性照顾需求,为护理人员开展健康指导提供依据,也为护理管理者开展培训和继续教育提供方向。方法选择2012年3-7月在山西省肿瘤医院通过病理检查确诊的结直肠癌接受手术的161例患者,在澳大利亚Bonevski设计的癌症患者支持性照顾需求调查问卷的基础上增加未保肛患者适用的造口支持需求维度进行问卷调查,观察结直肠癌患者术后支持性照顾需求各维度的需求率和得分情况。结果患者6个维度平均需求率为79．12％,平均未满足率为78．63％。患者心理需求得分为（2．71±0．56）分,照顾与支持需求得分为（2．66±0．46）分,生理及日常生活需求为（2．25±0．67）分,健康信息需求得分为（1．94±0．67）分,性需求得分为（1．88±1．25）分,造口需求得分为（0．66±1．18）分。术后支持性照顾需求各维度得分比较差异有统计学意义（F＝867．81, P＜0．05）。结论护理人员应全面了解患者的需求,及时调整护理服务内容。护理管理者应根据患者需求进行护士的继续教育工作,才能有利于护理学科的发展。     

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。