Morrison Caroline F, Pai Ahna L H, Martsolf Donna
1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
2 University of Cincinnati, College of Nursing, Cincinnati, OH, USA.
J Pediatr Oncol Nurs. 2018 Jan/Feb;35(1):36-42. doi: 10.1177/1043454217723864. Epub 2017 Aug 8.
Adolescents and young adults who experience hematopoietic stem cell transplant are at risk for self-management difficulties based on development, psychological comorbidities, and the complexity of the care regimen. Recommendations for practice change were designed to address facilitators and barriers to self-management for adolescents and young adults following hematopoietic stem cell transplant. As part of a grounded theory research study, 30 participants (17 adolescents and young adults and 13 of their caregivers) were individually interviewed and asked about facilitators and barriers to managing care and advice for health care providers. Participant responses were coded into categories, which were named with terms used by the participants. The number of participants who provided data per category was recorded. Self-management is generally characterized only in the ability to follow a prescribed care regimen. Participants indicated mental and emotional experiences as a result of treatment were indistinguishable from self-management activities. Facilitators included having a positive attitude, social support, organization, motivation, and information. Barriers included physical and psychological symptoms, isolation, difficulties with the medication regimen, single parenting, and having a bad attitude. Advice for health care providers included communicating effectively, treating patients holistically, and providing social support.
经历造血干细胞移植的青少年和青年，由于自身发育、心理合并症以及护理方案的复杂性，存在自我管理困难的风险。实践变革建议旨在解决造血干细胞移植后青少年和青年自我管理的促进因素和障碍。作为一项扎根理论研究的一部分，对30名参与者（17名青少年和青年及其13名照顾者）进行了单独访谈，询问他们在护理管理方面的促进因素和障碍以及对医疗保健提供者的建议。参与者的回答被编码为不同类别，这些类别用参与者使用的术语命名。记录了每个类别中提供数据的参与者数量。自我管理通常仅被定义为遵循规定护理方案的能力。参与者表示，治疗带来的心理和情感体验与自我管理活动难以区分。促进因素包括积极的态度、社会支持、组织能力、动力和信息。障碍包括身体和心理症状、孤立感、药物治疗方案的困难、单亲家庭以及态度消极。对医疗保健提供者的建议包括有效沟通、全面治疗患者以及提供社会支持。
