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口服抗癌药物自我管理概念分析。

A Concept Analysis of Oral Anticancer Agent Self-management.

机构信息

Author Affiliations: Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor (Ms Mason and Drs Harris and Jiang); Center for Psychiatric Oncology & Behavioral Sciences, Massachusetts General Hospital Cancer Center, Boston (Dr Greer).

出版信息

Cancer Nurs. 2022;45(2):E374-E387. doi: 10.1097/NCC.0000000000000934.

Abstract

BACKGROUND

The rapid development and adoption of oral anticancer agents (OAAs) for cancer management have shifted patients' roles from recipient to owner of their care delivery, assuming their responsibilities for self-managing their OAA treatments at home, while the concept of oral anticancer agent self-management (OAA-SM) has not been well clarified and defined.

OBJECTIVE

This study was to clarify the concept of OAA-SM and identify major components, influential factors, and consequences of OAA-SM, as well as propose a representative conceptual model of OAA-SM.

METHODS

A literature review was conducted concerning the concept and application of OAA-SM. The Walker and Avant method for concept analysis was utilized to guide the examination of OAA-SM.

RESULTS

OAA-SM is a multifaceted and dynamic process that requires continuous adaptation by patients as multiple self-management challenges can emerge throughout OAA treatments. The defining attributes of OAA-SM include OAA adherence, adverse-effect self-management, patient-provider communication, and OAA safe storage, handling, and administration practices. Oral anticancer agent-SM is potentially influenced by a variety of patient-related, OAA-related, and healthcare system factors. Effective OAA-SM is associated with better patient and healthcare outcomes.

CONCLUSIONS

The clarification of the concept of OAA-SM and the identification of attributes of OAA-SM and their interrelationships contribute to the body of knowledge in OAA-SM.

IMPLICATIONS FOR PRACTICE

This concept analysis provides the foundation to increase healthcare providers' understanding of patients' needs for OAA-SM support and guides the development of patient-centered interventions to empower and engage patients and their families in effective OAA-SM, and improve patients' quality of life and care.

摘要

背景

癌症管理中口服抗癌药物(OAAs)的快速发展和采用已经将患者的角色从接受者转变为其护理提供者,承担着在家中自我管理 OAAs 治疗的责任,而口服抗癌药物自我管理(OAA-SM)的概念尚未得到充分阐明和定义。

目的

本研究旨在阐明 OAA-SM 的概念,确定其主要组成部分、影响因素和后果,并提出 OAA-SM 的代表性概念模型。

方法

对 OAA-SM 的概念和应用进行文献回顾。采用 Walker 和 Avant 概念分析方法指导对 OAA-SM 的检查。

结果

OAA-SM 是一个多方面且动态的过程,需要患者不断适应,因为在 OAAs 治疗过程中可能会出现多种自我管理挑战。OAA-SM 的定义属性包括 OAAs 依从性、不良反应自我管理、医患沟通以及 OAA 安全储存、处理和管理实践。OAA-SM 可能受到多种患者相关、OAA 相关和医疗保健系统因素的影响。有效的 OAA-SM 与更好的患者和医疗保健结果相关。

结论

阐明 OAA-SM 的概念以及确定 OAA-SM 的属性及其相互关系有助于增加 OAA-SM 知识体系。

实践意义

该概念分析为提高医疗保健提供者对患者 OAA-SM 支持需求的理解提供了基础,并指导制定以患者为中心的干预措施,赋予患者及其家属有效管理 OAA-SM 的能力,并改善患者的生活质量和护理。

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