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治疗后头颈部癌症幸存者的自我管理方法:一项定性研究。

Post-treatment head and neck cancer survivors' approaches to self-management: A qualitative study.

机构信息

School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.

College of Nursing, University of Iowa, Iowa City, IA, USA.

出版信息

Eur J Oncol Nurs. 2021 Jun;52:101944. doi: 10.1016/j.ejon.2021.101944. Epub 2021 Mar 21.

Abstract

PURPOSE

Post-treatment head and neck cancer (HNC) survivors contend with distinct, long-term challenges related to cancer treatments that impact their day-to-day lives. Alongside follow-up cancer care, they also must be responsible for the daily management of often intrusive physical and psychological symptoms, as well as maintaining their health and a lifestyle to promote their well-being. The purpose of this study was to identify HNC survivors' approaches toward engagement in self-management activities.

METHODS

Post-treatment HNC survivors (N=22) participated in the study through purposeful sampling. Participants were eligible if they 1) had a history of upper aerodigestive tract cancer; 2) completed their most recent primary treatment (i.e. chemotherapy, radiation, and surgery) more than eighteen months prior and had no evidence of HNC, and 3) could speak in English. A semi-structured interview was used. Data was analyzed using content analysis.

RESULTS

We identified three approaches that survivors took towards self-management activities: taking charge, living with it, and engaging as needed. Our results showed that taking charge is when survivors take an active role in evaluating their health and taking action subsequently; as needed represents engaging in self-management as necessary; and living with it reflects adapting to the symptoms and side effects without managing them.

CONCLUSIONS

We propose self-management approaches as a novel mechanism to understand the relationship between survivors' characteristics and health preferences and their self-management. It is important for clinicians to highlight the variation in individuals 'self-management approaches as they work to identify tailored patient-centered strategies that compliment specific patient needs.

摘要

目的

治疗后头颈部癌症(HNC)幸存者面临与癌症治疗相关的独特的长期挑战,这些挑战影响他们的日常生活。除了后续的癌症护理外,他们还必须负责日常管理通常具有侵入性的身体和心理症状,同时保持健康的生活方式以促进他们的幸福感。本研究的目的是确定 HNC 幸存者参与自我管理活动的方法。

方法

通过有目的的抽样,对治疗后的 HNC 幸存者(N=22)进行了研究。参与者符合以下条件:1)患有上呼吸道癌症;2)在 18 个月前完成最近的主要治疗(即化疗、放疗和手术)且没有 HNC 的证据;3)能够用英语交流。采用半结构式访谈。使用内容分析法分析数据。

结果

我们确定了幸存者采取的三种自我管理活动方法:主动管理、接受现状和按需管理。我们的研究结果表明,主动管理是指幸存者积极评估自己的健康状况并采取相应的行动;按需管理表示根据需要进行自我管理;接受现状则反映了适应症状和副作用而不进行管理的情况。

结论

我们提出自我管理方法作为一种新的机制来理解幸存者的特征、健康偏好与自我管理之间的关系。对于临床医生来说,强调个体自我管理方法的差异很重要,因为他们旨在确定量身定制的以患者为中心的策略,以满足特定患者的需求。

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