头颈部癌症患者的心理体验:系统评价和荟萃分析。

The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis.

机构信息

School of Nursing and Midwifery, University of Dundee, Dundee City, UK.

出版信息

Psychooncology. 2013 Dec;22(12):2648-63. doi: 10.1002/pon.3343. Epub 2013 Jul 10.

Abstract

OBJECTIVE

To summarise patients' experiences of head and neck cancer (HNC) by examining the findings of existing qualitative studies

METHODS

We undertook a systematic review and meta-synthesis of qualitative studies in 29 published articles using Noblit and Hare's 'meta-ethnography' approach to synthesise findings. The inclusion criteria were primary qualitative studies, focusing on HNC patients' experience and an English abstract. Seven databases were systematically searched.

RESULTS

The articles focused on the experience of having HNC, the experience of treatments and the role of information. Our synthesis identified six core concepts-uncertainty and waiting, disruption to daily life, the diminished self, making sense of the experience, sharing the burden and finding a path. People experienced significant disruption to normal daily activities, because of the physical and emotional effects of HNC and its treatment. Day-to-day challenges were compounded by social and existential changes and a palpable loss of the individual's sense of self and future. In order to find a way through the considerable uncertainty and daily challenge of living with and beyond HNC, patients made continual efforts to make sense of their experience. Supportive relationships with their social network, HNC peers and healthcare professionals were particularly important, but support following treatment completion was sometimes limited. Perceptions of the future were affected by whether they saw life as diminished, merely changed or even enhanced by the experience of cancer.

CONCLUSIONS

This review supports further specific research into these emerging themes and provides a context for future work, informing interventions to improve patients' experiences.

摘要

目的

通过检查现有定性研究的结果,总结头颈部癌症(HNC)患者的体验。

方法

我们使用 Noblit 和 Hare 的“元民族志”方法,对 29 篇已发表文章中的定性研究进行了系统的综述和元综合,以综合研究结果。纳入标准为主要定性研究,重点关注 HNC 患者的体验和英文摘要。系统地搜索了七个数据库。

结果

这些文章主要关注患有 HNC 的体验、治疗体验以及信息的作用。我们的综合分析确定了六个核心概念——不确定性和等待、日常生活的中断、自我的削弱、理解体验、分担负担和找到出路。由于 HNC 及其治疗的身体和情绪影响,人们的正常日常生活受到了重大干扰。社会和存在的变化以及个人自我和未来的明显丧失,使日常挑战更加复杂。为了找到一种方法来应对与 HNC 共存和超越的巨大不确定性和日常挑战,患者不断努力理解自己的体验。与社交网络、HNC 同行和医疗保健专业人员的支持关系尤其重要,但治疗结束后的支持有时有限。他们对未来的看法受到他们对生活的看法的影响,即认为生活因癌症经历而减少、仅仅改变或甚至增强。

结论

本综述支持对这些新出现的主题进行进一步的具体研究,并为未来的工作提供了背景,为改善患者体验的干预措施提供了信息。

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