Department of Palliative Medicine, University Medical Center Göttingen, Göttingen, Germany.
Institute for General Practice, Hannover Medical School, Hannover, Germany.
PLoS One. 2019 May 14;14(5):e0216778. doi: 10.1371/journal.pone.0216778. eCollection 2019.
Caring for patients with advanced lung cancer is of high relevance in different clinical settings. Lung cancer is among the most common causes of death from malignant neoplasms worldwide; with increasing prevalence and mortality.
To get a better understanding of individual patients' needs, exploring the experiences and meaning of living with advanced lung cancer at the end of life, and to develop strategies for improving patient-centred care in Germany.
Qualitative explorative interview study with patients, using grounded theory.
SETTING/PARTICIPANTS: A sample of 17 adults living with advanced lung cancer in Lower Saxony/Germany was recruited in two university hospitals. Patients were asked to tell of their experiences of living with advanced lung cancer. The emphasis of this study was the period of palliative tumour therapy.
The main phenomenon of living with advanced lung cancer is the feeling of having to redefine one's own existence, such as social roles within and outside the family. The diagnosis trigger powerlessness, which can lead to information passivity, followed by acceptance of aggressive tumour treatment. Patients perceive a high degree of psychological and social stress, without being able to express this. There is a lack of regular appropriate psychosocial care accompanying chemotherapy. Patients ascribe their physical suffering to the side effects of tumour treatment, which may trigger a desire to die. Finally, patients tend to hide their individual needs, even when asked.
Regarding the patients' needs, greater emphasis must be placed on psychosocial care as part of the biopsychosocial model to adequately consider the patients' concerns. Assessments can be helpful to enhance communication at an early stage across all professions into the multi-professional therapy.
在不同的临床环境中,照顾晚期肺癌患者具有高度相关性。肺癌是全球最常见的恶性肿瘤死亡原因之一;其发病率和死亡率不断上升。
深入了解个体患者的需求,探索终末期肺癌患者的生活体验和意义,并制定在德国改善以患者为中心的护理的策略。
采用扎根理论的定性探索性访谈研究。
地点/参与者:在德国下萨克森州的两家大学医院招募了 17 名患有晚期肺癌的成年人作为样本。要求患者讲述他们患有晚期肺癌的生活经历。本研究的重点是姑息性肿瘤治疗阶段。
晚期肺癌患者的主要生活现象是重新定义自身存在的感觉,例如家庭内外的社会角色。诊断引发无力感,这可能导致信息被动,继而接受积极的肿瘤治疗。患者感到高度的心理和社会压力,但无法表达出来。在化疗过程中缺乏定期适当的心理社会护理。患者将身体上的痛苦归因于肿瘤治疗的副作用,这可能会引发想死的念头。最后,患者往往会隐瞒自己的个人需求,即使被问到也是如此。
在考虑患者的需求时,必须更加重视心理社会护理,作为生物心理社会模式的一部分,以充分考虑患者的关注。评估可以帮助提高所有专业人员在多专业治疗中的早期沟通。