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癌症治疗期间接受尊严疗法的新诊断晚期癌症患者的观点。

Perspectives of newly diagnosed advanced cancer patients receiving dignity therapy during cancer treatment.

作者信息

Dose Ann Marie, Rhudy Lori M

机构信息

Department of Nursing, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

出版信息

Support Care Cancer. 2018 Jan;26(1):187-195. doi: 10.1007/s00520-017-3833-2. Epub 2017 Jul 21.

Abstract

PURPOSE

Dignity therapy is a psychosocial intervention that has been used primarily at the end of life to improve quality of life and other patient outcomes, but many individuals are unable to complete it due to health decline and death. The purpose of this study was to identify what individuals with advanced pancreatic or lung cancer with limited life expectancy, undergoing active cancer treatment describe during the dignity therapy intervention as important to them when not immediately facing end of life.

METHODS

Twenty patients undergoing chemotherapy for advanced cancer participated in a dignity therapy intervention study. Initial interviews were analyzed using descriptive content analysis.

RESULTS

Family provided the overall context and background for emerging themes of defining events, accomplishments, and God's plan, which led to lessons learned, and resulted in messages of hope. Interviews were often autobiographical in nature and contained much reminiscence, consistent with dignity therapy's intent. Few participants spoke about their cancer diagnoses during the interview.

CONCLUSIONS

This study adds unique insight into the use of dignity therapy for those still receiving active cancer treatment, different from work by others in which it was offered only at end of life. As part of supportive care, clinicians need to validate the importance of family to those with advanced cancer and to provide opportunities for patients to share what they have learned throughout life and to impart messages of hope to those closest to them.

摘要

目的

尊严疗法是一种社会心理干预措施,主要用于临终阶段以提高生活质量及改善其他患者结局,但许多人因健康状况恶化和死亡而无法完成该疗法。本研究的目的是确定预期寿命有限、正在接受积极癌症治疗的晚期胰腺癌或肺癌患者在尊严疗法干预过程中,在并非立即面临生命终点时,认为对他们重要的事情。

方法

20名正在接受晚期癌症化疗的患者参与了一项尊严疗法干预研究。采用描述性内容分析法对初始访谈进行分析。

结果

家庭为界定事件、成就和上帝的计划等新出现的主题提供了整体背景和情境,这些主题带来了经验教训,并产生了希望的信息。访谈本质上往往是自传式的,且包含很多回忆,这与尊严疗法的意图一致。很少有参与者在访谈中谈及他们的癌症诊断情况。

结论

本研究为仍在接受积极癌症治疗的患者使用尊严疗法提供了独特的见解,这与其他仅在临终阶段提供尊严疗法的研究不同。作为支持性护理的一部分,临床医生需要认可家庭对晚期癌症患者的重要性,并为患者提供机会,让他们分享一生所学,并向最亲近的人传递希望的信息。

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