Hopkinson Jane, Wright David, Corner Jessica
Macmillan Research Unit, University of Southampton, Southampton, UK.
J Adv Nurs. 2006 May;54(3):304-12. doi: 10.1111/j.1365-2648.2006.03818.x.
This paper reports a study of the experience of and concerns about weight loss described by patients with advanced cancer, their caregivers and nurse specialists.
Weight loss is reported to be one of the commonest symptoms experienced by patients with advanced cancer. There is evidence that it can be of concern to patients and their caregivers. However, little is known about why this is the case or how people might be helped to live with the symptom.
An exploratory study with a purposive sample of 30 patients, 23 caregivers, and 14 specialist nurses from the South of England was conducted in 2003. The in-depth interviews focused on the experience of weight loss and its management. Interviews were transcribed verbatim, then analysed using an approach informed by Wolcott's framework for qualitative data analysis and Miles and Huberman's 'mixed strategy for cross-case analysis'.
Concern was experienced when advanced cancer became visible through weight loss. Visible weight loss symbolized proximity to death, loss of control and both physical and emotional weakness. Despite this, weight loss was not routinely assessed by palliative care nurse specialists, who, like others in the patient's social network, respected a weight loss taboo in the belief that little could be done to help people live with the symptom.
Weight loss-related concern might be mitigated if clinicians adopted a systematic and proactive approach to the management of the symptom that breaks through the weight loss taboo.
本文报告了一项关于晚期癌症患者、其照护者及专科护士所描述的体重减轻经历与担忧的研究。
据报道，体重减轻是晚期癌症患者最常见的症状之一。有证据表明，这可能会引起患者及其照护者的担忧。然而，对于为何如此以及如何帮助人们应对这一症状，我们知之甚少。
2003年，对来自英格兰南部的30名患者、23名照护者和14名专科护士进行了一项有目的抽样的探索性研究。深入访谈聚焦于体重减轻的经历及其管理。访谈逐字记录，然后采用基于沃尔科特定性数据分析框架以及迈尔斯和休伯曼“跨案例分析混合策略”的方法进行分析。
当晚期癌症通过体重减轻显现出来时，人们会感到担忧。明显的体重减轻象征着接近死亡、失去控制以及身体和情感上的虚弱。尽管如此，姑息治疗专科护士并没有常规评估体重减轻情况，他们和患者社交网络中的其他人一样，遵循着体重减轻禁忌，认为对于帮助人们应对这一症状无能为力。
如果临床医生采取系统且积极主动的方法来管理这一症状，打破体重减轻禁忌，那么与体重减轻相关的担忧可能会得到缓解。
