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与癌症幸存者进行以患者为中心的沟通:探索后续辅导谈话的意义。

Person-centred communication with cancer survivors: Exploring the meaning of follow-up coaching conversations.

作者信息

Timmermann Connie, Ammentorp Jette, Birkelund Regner

机构信息

Centre for Research in Patient Communication, Odense University Hospital, University of Southern Denmark, Odense, Denmark.

Lillebaelt Hospital, Vejle, Denmark.

出版信息

Scand J Caring Sci. 2023 Mar;37(1):243-249. doi: 10.1111/scs.13007. Epub 2021 May 24.

Abstract

AIM

The aim of this study was to explore the meaning of a coaching intervention for cancer survivors.

BACKGROUND

Cancer survivors often experience existential concerns and worries after adjuvant treatment. A number of "care transition interventions" have been developed to improve person-centred care by empowering patients. Several of these interventions include a "care transition coach". A coaching approach to communication used in health care communication have among others shown to assists in establishing confidential relationships between health professionals, increase the patient's well-being and support the patient's experience of being met and viewed as a whole person.

DESIGN

This is a qualitative study using semi-structured interviews to explore the meaning of a coaching intervention. In analyzing and interpreting the qualitative interviews Ricoeur's theory of interpretation was applied.

METHOD

The intervention consisted of two parts: (1) a two-day training program in coaching for nurses and (2) a specially developed communication intervention for cancer survivors.

RESULTS AND DISCUSSION

The analysis of the transcribed interview material led to the development of two themes: (1) Support in moving forward in life, and (2) An opportunity to talk about existential thoughts and worries. Our results show how the experience of cancer, even when cured, leaves the survivors with profound existential worries. The cancer survivors described how coaching conversations allowed them to express their current concerns and provided them with an opportunity to discuss wider issues than treatment, symptoms, and after-effects, which had been the main focus during treatment.

CONCLUSION

The time immediately after the end of adjuvant treatment can be challenging, with many existential concerns and opposing emotions. We found that the follow-up coaching conversations performed helped the cancer survivors to process many of these difficult thoughts and feelings.

摘要

目的

本研究旨在探讨针对癌症幸存者的辅导干预措施的意义。

背景

癌症幸存者在辅助治疗后常常会经历生存方面的担忧。为了通过增强患者能力来改善以患者为中心的护理,已经开发了一些“护理过渡干预措施”。其中一些干预措施包括“护理过渡教练”。医疗保健沟通中使用的辅导沟通方法除其他外,已显示有助于在医疗专业人员之间建立保密关系,提高患者的幸福感,并支持患者被视为完整的人的体验。

设计

这是一项定性研究,使用半结构化访谈来探讨辅导干预措施的意义。在分析和解释定性访谈时,应用了利科的解释理论。

方法

干预措施包括两个部分:(1)为护士提供为期两天的辅导培训计划,以及(2)为癌症幸存者专门开发的沟通干预措施。

结果与讨论

对转录的访谈材料的分析产生了两个主题:(1)在生活中向前迈进的支持,以及(2)谈论生存想法和担忧的机会。我们的结果表明,癌症经历,即使治愈后,也会给幸存者留下深刻的生存担忧。癌症幸存者描述了辅导对话如何使他们能够表达当前的担忧,并为他们提供了一个讨论比治疗、症状和后遗症更广泛问题的机会,而这些问题在治疗期间一直是主要关注点。

结论

辅助治疗结束后的这段时间可能具有挑战性,存在许多生存方面的担忧和相反的情绪。我们发现进行的后续辅导对话帮助癌症幸存者处理了许多这些困难的想法和感受。

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