Sibeoni Jordan, Picard Camille, Orri Massimiliano, Labey Mathilde, Bousquet Guilhem, Verneuil Laurence, Revah-Levy Anne
Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, 69 rue du LTC Prud'hon, 95107, Argenteuil, France.
ECSTRRA Team, UMR-1153, Inserm, Paris Diderot University, Sorbonne Paris Cite, Paris, France.
BMC Cancer. 2018 Oct 4;18(1):951. doi: 10.1186/s12885-018-4868-6.
Patients' quality of life has become a major objective of care in oncology. At the same time, it has become the object of increasing interest by researchers, working with both quantitative and qualitative methods. Progress in oncology has enabled more patients to survive longer, so that cancer is increasingly often a chronic disease that requires long-term treatment that can have negative effects on patients' quality of daily life. Nonetheless, no qualitative study has explored what patients report affects their quality of daily life during the treatment period. This study is intended to fill this gap.
We conducted a multicenter qualitative study based on 30 semi-structured interviews. Participants, purposively selected until data saturation, had diverse types of cancer and had started treatment at least 6 months before interview. Data were examined by thematic analysis.
Our analysis found two themes: (1) what negatively affected for patient's quality of daily life during the treatment period, a question to which patients responded by talking only about the side effects of treatment; and (2) what positively affected their quality of daily life during the treatment period with three sub-themes: (i) The interest in having -investing in - a support object that can be defined as an object, a relationship or an activity particularly invested by the patients which makes them feel good and makes the cancer and its treatment bearable, (ii)The subjective perception of the efficacy of the antitumor treatment and (iii) the positive effects of relationships, with friends and family, and also with their physician.
Patients must be involved in their care if they are to be able to bear their course of treatment and find ways to endure the difficult experience of cancer care. The support object represents an important therapeutic lever that can be used by their oncologists. They should be interested in their support objects, in order to support the patients in this investment and to help them to maintain it throughout the health care pathway. Furthermore, showing interest in this topic, important to the patient, could improve the physician-patient relation without using up very much of the physician's time.
患者的生活质量已成为肿瘤学护理的主要目标。与此同时，它也成为研究人员越来越感兴趣的对象，他们采用定量和定性方法进行研究。肿瘤学的进展使更多患者能够长期存活，因此癌症越来越多地成为一种需要长期治疗的慢性病，而这种治疗可能会对患者的日常生活质量产生负面影响。尽管如此，尚无定性研究探讨患者报告的在治疗期间影响其日常生活质量的因素。本研究旨在填补这一空白。
我们基于30次半结构化访谈进行了一项多中心定性研究。有目的地选择参与者，直至数据饱和，他们患有不同类型的癌症，且在访谈前至少已开始治疗6个月。通过主题分析对数据进行检查。
我们的分析发现了两个主题：（1）在治疗期间对患者日常生活质量产生负面影响的因素，患者仅通过谈论治疗的副作用来回答这个问题；（2）在治疗期间对其日常生活质量产生积极影响的因素，包括三个子主题：（i）对拥有——投入——一个支持对象的兴趣，这个支持对象可以被定义为一个对象、一种关系或一项活动，患者特别投入其中，这让他们感觉良好，并使癌症及其治疗变得可以承受，（ii）对抗肿瘤治疗疗效的主观认知，以及（iii）与朋友、家人以及医生的关系所产生的积极影响。
如果患者要能够承受其治疗过程并找到忍受癌症护理艰难经历的方法，就必须让他们参与到自己的护理中。支持对象是肿瘤学家可以利用的一个重要治疗手段。他们应该关注患者的支持对象，以便在这种投入中支持患者，并帮助他们在整个医疗过程中维持这种投入。此外，对这个对患者很重要的话题表现出兴趣，可以在不占用医生太多时间的情况下改善医患关系。
