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通过实践学习:经验知识共享对于满足德国结直肠癌患者信息需求的重要性——一项定性研究

Learning-by-doing: the importance of experiential knowledge sharing for meeting the information needs of people with colorectal cancer in Germany-a qualitative study.

作者信息

Kaiser Maleen, Adami Sandra, Lucius-Hoene Gabriele, Muller-Nordhorn Jacqueline, Goerling Ute, Breuning Martina, Holmberg Christine

机构信息

Institute of Public Health, Charite Universitätsmedizin Berlin, Berlin, Germany.

Fachklinik für Psychosomatische Medizin und Psychotherapie, Celenus Fachklinik Freiburg, Freiburg, Germany.

出版信息

BMJ Open. 2021 Feb 23;11(2):e038460. doi: 10.1136/bmjopen-2020-038460.

Abstract

OBJECTIVE

The aim of this article is to understand how, when and why the topics of information and information needs arise when people diagnosed with colorectal cancer (CRC) narrate their illness experiences.

METHODS

Guided by principles of grounded theory, a qualitative interview study was conducted that collected a wide variety of illness experiences with CRC in Germany using maximum variation sampling. Sampling criteria included place of residence, age at interview, age at diagnosis, treatment, disease course and sociodemographic factors such as varying family backgrounds and professions.

SETTING AND PARTICIPANTS

Men and women diagnosed with CRC in different parts of Germany were sought via physicians, social workers and psychologists in hospital settings, organisations offering psychosocial support for patients with cancer, self-help groups, rehabilitation centres, newspapers and personal contacts. The interviewees in the final sample (n=41) had been diagnosed with CRC between 4 weeks and 36 years prior to the interview.

RESULTS

Three inter-related categories of information needs emerged from the analysis: the need for non-medical information for daily life; the challenge of integrating the bodily changes that accompany CRC in everyday life; and sources of non-medical information concerning handling daily life. Learning to live with the bodily changes of CRC in everyday life was described as a long process of learning-by-doing. While sources for medical information were clear, finding practical information was often a challenge. The best source of such information was often seen to be other people living with the disease, who shared their experiential knowledge, as well as stoma and nutritional therapists.

CONCLUSION

Information needs are part of the process and struggle to normalise everyday life after a disruptive diagnosis and treatment. Providing access to practical knowledge and information from others with CRC experience may be an important resource for patient support.

摘要

目的

本文旨在了解被诊断为结直肠癌(CRC)的患者在讲述其疾病经历时,信息及信息需求的主题是如何、何时以及为何出现的。

方法

在扎根理论原则的指导下,开展了一项定性访谈研究,采用最大差异抽样法收集了德国各类结直肠癌疾病经历。抽样标准包括居住地、访谈时年龄、诊断时年龄、治疗情况、病程以及社会人口学因素,如不同的家庭背景和职业。

背景与参与者

通过医院环境中的医生、社会工作者和心理学家、为癌症患者提供心理社会支持的组织、自助团体、康复中心、报纸以及个人人脉,在德国不同地区寻找被诊断为结直肠癌的男性和女性。最终样本中的受访者(n = 41)在访谈前4周至36年被诊断为结直肠癌。

结果

分析得出了三类相互关联的信息需求:日常生活中非医疗信息的需求;将结直肠癌伴随的身体变化融入日常生活的挑战;以及处理日常生活的非医疗信息来源。在日常生活中学会与结直肠癌的身体变化共处被描述为一个漫长的边做边学的过程。虽然医疗信息来源明确,但找到实用信息往往是一项挑战。这类信息的最佳来源通常被认为是其他患此病的人,他们分享自己的经验知识,还有造口治疗师和营养治疗师。

结论

信息需求是诊断和治疗受到干扰后使日常生活正常化这一过程和挣扎的一部分。提供来自有结直肠癌经历的其他人的实用知识和信息,可能是支持患者的重要资源。

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