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门诊癌症手术后康复过程中照顾者负担的定性分析。

A qualitative analysis of caregiver burden during the recovery process in ambulatory cancer surgery.

机构信息

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Josie Robertson Surgery Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

出版信息

Support Care Cancer. 2022 Jul;30(7):5713-5721. doi: 10.1007/s00520-022-06991-x. Epub 2022 Mar 23.

Abstract

PURPOSE

Cancer impacts caregivers as well as patients. Ambulatory oncology surgeries requiring a short hospital stay place additional responsibility on informal caregivers as they help patients navigate their post-operative recovery at home, and determine if symptoms are expected or emergent. Our objective was to explore the experience of informal caregivers during patients' ambulatory cancer surgery and then recovery at home with remote monitoring of symptoms via web-based patient-reported outcomes questionnaire ("Recovery Tracker").

METHODS

Semi-structured interviews were conducted with caregivers from a larger sample participating in a randomized trial of the Recovery Tracker. Thematic analysis was applied to derive key themes and codes via NVivo qualitative analysis software (QSR International Inc.). Recruitment was conducted iteratively to ensure a heterogenous sample and thematic saturation.

RESULTS

Twenty-three semi-structured interviews were conducted. Four main themes emerged: (1) Predictability reduced stress among caregivers; (2) Unexpected events caused stress for caregivers; (3) The importance of a caregiver being present during the recovery process; and (4) Caregiver involvement in remote monitoring of symptoms was minimal.

CONCLUSION

Caregivers report not being overly burdened by the ambulatory surgery process, but they are very sensitive to any deviations from what they expected to happen. Further research and clinical practice on caregivers in the ambulatory setting should focus on how to set expectations and avoid unexpected events.

摘要

目的

癌症不仅影响患者,还会对照顾者造成影响。需要短期住院的门诊肿瘤手术会给非正规照顾者带来额外的责任,因为他们需要帮助患者在家中进行术后康复,并确定症状是预期的还是紧急的。我们的目的是探索非正规照顾者在患者接受门诊癌症手术及其在家中通过基于网络的患者报告结局问卷(“Recovery Tracker”)进行远程症状监测后的体验。

方法

对来自更大样本量、参与 Recovery Tracker 随机试验的照顾者进行半结构化访谈。采用 NVivo 定性分析软件(QSR International Inc.)对主题进行分析,以提取关键主题和代码。通过迭代招募来确保样本的异质性和主题的饱和性。

结果

共进行了 23 次半结构化访谈。得出了四个主要主题:(1)可预测性降低了照顾者的压力;(2)意外事件给照顾者带来了压力;(3)在康复过程中照顾者在场的重要性;(4)照顾者对症状的远程监测参与度较低。

结论

照顾者报告说,门诊手术过程并没有给他们带来过重的负担,但他们对任何与预期不符的事情都非常敏感。在门诊环境中对照顾者的进一步研究和临床实践应侧重于如何设定期望并避免意外事件。

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