College of Nursing and Midwifery Brisbane Centre, Charles Darwin University, Brisbane, Australia.
School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong.
BMC Palliat Care. 2021 Jun 7;20(1):83. doi: 10.1186/s12904-021-00774-7.
Studies in the West have demonstrated that appropriate informational support is a vital component of cancer care, with positive effects on both patients and their informal caregivers. Since little is known about the information needs of advanced cancer patients and informal caregivers in China, where 'silence as virtue' is much more valued and the communication style is less open, this study was therefore conducted to elaborate the information needs of advanced cancer patients and informal caregivers as well as to explore their perceptions and experiences regarding their unmet information needs in the Chinese context.
This sub-study of a previous cross-sectional survey utilized a qualitative descriptive study design. The approach involved semi-structured interviews that followed an interview guide to collect data. Eligible participants were the advanced cancer patients and informal caregivers who had participated in the previous cross-sectional survey and reported unmet information needs. Each interview was audio-recorded and transcribed verbatim. Descriptive content analysis was used to analyze the data.
Seventeen advanced cancer patients and 15 informal caregivers with unmet information needs participated in the semi-structured interviews, with ages ranging from 32 to 63 years old for patients and from 32 to 70 for informal caregivers. Four categories were extracted from the interviews with the patients and caregivers: (1) types of unmet information needs; (2) reasons for information needs not being met; (3) preferences for the provision of information; and (4) meaning and role of information. Each category had two to four sub-categories for both the patients and the caregivers, which were similar but not completely the same.
The findings indicated that the provision of appropriate information could promote informed decision-making and greater satisfaction with treatment options, reductions in psychological disturbances, and enhanced confidence and ability in self-management and capacity in caregiving. Moreover, information on Traditional Chinese Medicine and food therapy should be increased, particularly for patients at the follow-up stage, while the amount of information on prognosis should be flexible as it could increase patients' and caregivers' psychological burden. Healthcare professionals were the most preferred information provider, although their heavy workload resulted in time constraints. In this case, they should provide information to patients and caregivers together as a 'whole unit.' At the same time, the value of separate conversations should also be recognized as some caregivers preferred to conceal unpleasant information from the patient.
西方的研究表明,适当的信息支持是癌症护理的重要组成部分,对患者及其非正式照顾者都有积极影响。由于在中国,“沉默是美德”的观念更为深入人心,沟通方式也不那么开放,因此人们对中国晚期癌症患者和非正式照顾者的信息需求知之甚少。本研究旨在详细阐述晚期癌症患者和非正式照顾者的信息需求,并探讨他们在中国背景下对未满足信息需求的认知和体验。
本研究是一项先前横断面调查的子研究,采用定性描述性研究设计。方法包括采用访谈指南进行半结构化访谈,以收集数据。合格的参与者是参加先前横断面调查并报告存在未满足信息需求的晚期癌症患者和非正式照顾者。每次访谈均进行录音并逐字转录。采用描述性内容分析法对数据进行分析。
17 名晚期癌症患者和 15 名存在未满足信息需求的非正式照顾者参加了半结构化访谈,患者年龄为 32 至 63 岁,非正式照顾者年龄为 32 至 70 岁。从患者和照顾者的访谈中提取了四个类别:(1)未满足信息需求的类型;(2)信息需求未得到满足的原因;(3)信息提供偏好;以及(4)信息的意义和作用。每个类别均有患者和照顾者的 2 至 4 个子类别,两者相似但不完全相同。
研究结果表明,提供适当的信息可以促进知情决策,提高对治疗方案的满意度,减少心理困扰,增强自我管理信心和能力,以及提高照顾能力。此外,应该增加中医和食疗方面的信息,特别是在随访阶段的患者,而预后方面的信息量应保持灵活,因为它可能会增加患者和照顾者的心理负担。医护人员是最受欢迎的信息提供者,但他们的工作量大,时间有限。在这种情况下,他们应该将患者和照顾者作为一个“整体”一起提供信息。同时,也应认识到单独谈话的价值,因为一些照顾者更愿意向患者隐瞒不愉快的信息。