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患者对成人晚期癌症正念干预的体验:定性分析。

Patients' experiences of a mindfulness intervention for adults with advanced cancer: a qualitative analysis.

机构信息

Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.

Psychological Medicine, University of Otago, Christchurch, New Zealand.

出版信息

Support Care Cancer. 2020 Oct;28(10):4911-4921. doi: 10.1007/s00520-020-05331-1. Epub 2020 Feb 3.

Abstract

PURPOSE

People with advanced cancer often experience significant emotional turmoil that accompanies their diagnosis and cancer-related treatments. Therefore, psychological interventions become relevant to address these impacts; however, there is a lack of research into the psychological support needs of those with advanced cancer (those not yet in palliative or end-of-life stages). In this context, we developed a mindfulness-based intervention, Coping with Cancer Mindfully (CCM), to provide psychological and emotional support to adults with advanced cancer. This article reports on qualitative interviews from a mixed method study of the CCM intervention exploring its utility and the extent it provides psychological support to this population in a pre-post-intervention design.

METHODS

Adults with advanced cancer (stage III or IV) were recruited via cancer-related services in Christchurch, New Zealand. Thematic analysis was used to analyse the semi-structured interviews.

RESULTS

Twenty participants were interviewed. Thematic analysis showed that at baseline, participants were experiencing distress but few had been offered psychological support; they reported feeling vulnerable and battling their cancers, and were seeking help. Post-intervention interviews reported that most participants' perspectives had shifted, from a state of vulnerability to one of self-encouragement, increased optimism, and taking new actions regarding their situations. The CCM intervention was identified as a readily available and positive tool of support.

CONCLUSIONS

Our findings suggest that those with advanced cancer should be offered options of psychological support at any stage post-diagnosis. At such an intense period in their lives, people with advanced cancer are likely to benefit from tailored psychological interventions. The CCM intervention with its focus on acceptance, meaning in life, and mindful coping has been shown to be acceptable to participants and as a supportive tool.

摘要

目的

晚期癌症患者常常经历伴随诊断和癌症相关治疗而来的强烈情绪波动。因此,心理干预变得相关,以解决这些影响;然而,对于晚期癌症患者(尚未进入姑息或临终阶段)的心理支持需求的研究却很少。在这种情况下,我们开发了一种基于正念的干预措施,正念应对癌症(CCM),为晚期癌症成人提供心理和情感支持。本文报告了一项混合方法研究中对 CCM 干预措施的定性访谈,该研究探索了其在预 - 后干预设计中对这一人群的效用及其提供心理支持的程度。

方法

通过新西兰克赖斯特彻奇的癌症相关服务招募晚期癌症(III 或 IV 期)成年人。使用主题分析对半结构化访谈进行分析。

结果

对 20 名参与者进行了访谈。主题分析显示,在基线时,参与者经历了痛苦,但很少有人提供心理支持;他们报告感到脆弱,与癌症作斗争,并寻求帮助。干预后访谈报告说,大多数参与者的观点已经发生转变,从脆弱状态转变为自我鼓励、增加乐观和对自己的情况采取新行动的状态。CCM 干预被确定为一种现成的积极支持工具。

结论

我们的研究结果表明,应在诊断后任何阶段为晚期癌症患者提供心理支持的选择。在他们生命的这个紧张时期,晚期癌症患者可能会受益于量身定制的心理干预措施。CCM 干预措施侧重于接受、生活意义和正念应对,已被证明为参与者所接受,并作为一种支持工具。

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