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细胞减灭术和腹腔内热化疗术后14个月患者的日常生活体验——一项定性随访研究

Patients' experiences of their everyday life 14 months after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy - a qualitative follow-up study.

作者信息

Leo Swenne Christine, Jangland Eva, Arakelian Erebouni

机构信息

Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.

Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.

出版信息

Scand J Caring Sci. 2017 Dec;31(4):904-913. doi: 10.1111/scs.12412. Epub 2017 Jan 25.

Abstract

BACKGROUND

Patients with peritoneal carcinomatosis treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy have a long recovery process.

AIM

To describe patients' experiences of their everyday lives after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

METHOD

A follow-up study with a qualitative, descriptive design. Data were collected by individual, in-depth telephone interviews with 16 patients who had been treated for peritoneal carcinomatosis 14 months earlier at a university hospital in Sweden. The interviews were performed between May and June 2013 and analysed using systematic text condensation.

RESULTS

Five themes were identified: (i) finding one's new self and relating to the new situation; (ii) the disease making its presence felt through bodily complications or mental fatigue; (iii) worrying about the return of the disease and passing it on to one's children; (iv) experiencing difficulties contacting various care facilities, not having a clear plan for ongoing rehabilitation; and (v) the need for online support through the Internet and counselling for both patients and their family members.

CONCLUSIONS

Despite bodily complications, mental fatigue and worries about the return of the disease, the patient's everyday life was focused on finding his/her new self and adapting to the new circumstances. Difficulties in contacting care facilities and the lack of an ongoing medical and nursing rehabilitation plan called for a need for network support for patients and their families.

CLINICAL RELEVANCE

After advanced surgery, patients require a continuous medical and nursing rehabilitation plan, and a platform of support such as meetings via social media and Internet which would connect former patients and their families with future patients and their family members. A contact nurse with specific expertise should design an individual rehabilitation plan and continuously identify the individual needs for long-term support.

摘要

背景

接受细胞减灭术和腹腔内热灌注化疗的腹膜癌患者恢复过程漫长。

目的

描述细胞减灭术和腹腔内热灌注化疗后患者的日常生活体验。

方法

采用定性描述性设计的随访研究。通过对16例14个月前在瑞典一家大学医院接受腹膜癌治疗的患者进行个人深度电话访谈收集数据。访谈于2013年5月至6月进行,并采用系统文本浓缩法进行分析。

结果

确定了五个主题:(i)找到新的自我并适应新情况;(ii)疾病通过身体并发症或精神疲劳显现出来;(iii)担心疾病复发并传染给子女;(iv)在联系各种护理机构时遇到困难,没有明确的持续康复计划;(v)患者及其家属需要通过互联网获得在线支持和咨询。

结论

尽管存在身体并发症、精神疲劳以及对疾病复发的担忧,但患者的日常生活仍集中在找到新的自我并适应新环境上。联系护理机构困难以及缺乏持续的医疗和护理康复计划,表明患者及其家属需要网络支持。

临床意义

大手术后,患者需要持续的医疗和护理康复计划,以及一个支持平台,如通过社交媒体和互联网举行会议,将以前的患者及其家属与未来的患者及其家属联系起来。具有特定专业知识的联络护士应设计个性化的康复计划,并持续确定长期支持的个人需求。

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