Ball Hannah, Moore Sally, Leary Alison
ANP Oxford University Hospitals NHS Foundation Trust, Mesothelioma UK Chest Unit Offices, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, United Kingdom.
Retired CNS (Royal Marsden NHS Foundation Trust & Mesothelioma UK), The Royal Marsden, Downs Road, Sutton, SM2 5PT, United Kingdom.
Eur J Oncol Nurs. 2016 Dec;25:62-67. doi: 10.1016/j.ejon.2016.09.007. Epub 2016 Oct 12.
Psychological distress which adversely affects a person's experience of cancer has been shown to be highly prevalent in patients with mesothelioma. Historically, the assumption has been made that the evidence guiding the supportive care needs for lung cancer is relevant to those with mesothelioma. The objective of the study was to evaluate if the psychological care needs differ between patients with pleural mesothelioma and those with advanced lung cancer.
A search of MEDLINE, CINAHL, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO databases, grey literature and the Cochrane Library of Systematic Reviews identified 17 studies meeting a predefined inclusion criteria. These were critically appraised for quality. Data relating to psychological experiences was extracted which was then synthesised narratively and through a process of meta ethnography.
Common themes identified across the studies created 10 key concepts. These were uncertainty, normality, hope/hopelessness, stigma/blame/guilt, family/carer concern, physical symptoms, experience of diagnosis, iatrogenic distress, financial/legal and death and dying. Key similarities and differences were identified between the mesothelioma and lung cancer evidence.
There is limited research exploring the lived experiences of those with mesothelioma and lung cancer, with the majority of them having methodological and/or reporting concerns compromising the conclusions made. However, reoccurring themes in the evidence were found suggesting a number of areas where the psychological experience of mesothelioma differs from that of advanced lung cancer. These findings warrant further research to explore further and if proven, the need for the provision of specialist mesothelioma care services is affirmed.
心理困扰对癌症患者的体验有不利影响,在间皮瘤患者中已显示出高度普遍。从历史上看,一直假定指导肺癌支持性护理需求的证据与间皮瘤患者相关。本研究的目的是评估胸膜间皮瘤患者和晚期肺癌患者的心理护理需求是否存在差异。
检索MEDLINE、CINAHL、PsycARTICLES、心理学与行为科学文集、PsycINFO数据库、灰色文献和Cochrane系统评价图书馆,确定了17项符合预定义纳入标准的研究。对这些研究的质量进行了严格评估。提取了与心理体验相关的数据,然后通过叙述性综合和元民族志过程进行综合。
各项研究中确定的共同主题产生了10个关键概念。这些概念是不确定性、正常性、希望/绝望、耻辱/责备/内疚、家庭/照顾者担忧、身体症状、诊断经历、医源性困扰、财务/法律以及死亡与濒死。在间皮瘤和肺癌证据之间确定了关键的异同点。
探索间皮瘤和肺癌患者生活经历的研究有限,其中大多数研究在方法和/或报告方面存在问题,影响了所得出的结论。然而,在证据中发现了反复出现的主题,表明间皮瘤的心理体验在一些方面与晚期肺癌不同。这些发现值得进一步研究以深入探讨,如果得到证实,则肯定了提供专门的间皮瘤护理服务的必要性。