Coolbrandt A, Dierckx de Casterlé B, Wildiers H, Aertgeerts B, Van der Elst E, van Achterberg T, Milisen K
Department of Public Health and Primary Care, Center for Health Services and Nursing Research, KU Leuven, Leuven, Belgium.
Department of Oncology Nursing, University Hospitals Leuven, Leuven, Belgium.
Eur J Cancer Care (Engl). 2016 Jan;25(1):79-92. doi: 10.1111/ecc.12303. Epub 2015 Mar 6.
Given that chemotherapy treatments are done mostly in an outpatient setting, patients with cancer must deal with treatment-related symptoms mainly at home. Evidence suggests that they often feel left alone or unprepared to do so. This qualitative study explores how patients deal with chemotherapy-related symptoms in their home, which factors and ideas influence their self-management and what role professional caregivers play. One-off, semi-structured interviews were held with 28 adult patients with cancer being treated with chemotherapy. Using a Grounded Theory approach, we cyclically collected and analysed data to come to a thorough understanding of the major conceptual themes and their interconnections. Dealing with chemotherapy-related symptoms involves a process of experiencing and learning how side effects unfold over time and how to deal with them. Patients express very personal symptom experiences and symptom-management styles, which are shaped by personal factors (e.g. coping with cancer and cancer treatment, perceived level of control) and environmental factors (e.g. professionals' attitude, information resources). Improving symptom self-management support requires active exploration of the personal symptom experience and symptom-management style. Professional care should be tailored to the patient's perspective and should address personal and environmental determinants of their behaviour.
鉴于化疗治疗大多在门诊进行，癌症患者必须主要在家中应对与治疗相关的症状。有证据表明，他们常常感到孤立无援或对此毫无准备。这项定性研究探讨了患者在家中如何应对与化疗相关的症状，哪些因素和观念影响他们的自我管理，以及专业护理人员发挥了什么作用。对28名正在接受化疗的成年癌症患者进行了一次性的半结构化访谈。我们采用扎根理论方法，循环收集和分析数据，以全面理解主要的概念主题及其相互联系。应对与化疗相关的症状涉及一个体验和学习副作用如何随时间发展以及如何应对的过程。患者表达了非常个人化的症状体验和症状管理方式，这些受到个人因素（如应对癌症和癌症治疗、感知的控制水平）和环境因素（如专业人员的态度、信息资源）的影响。改善症状自我管理支持需要积极探索个人症状体验和症状管理方式。专业护理应根据患者的观点进行调整，并应解决影响其行为的个人和环境决定因素。
