Yale University, New Haven, CT, USA.
Department of Population Sciences, City of Hope, Duarte, CA, USA.
J Cancer Surviv. 2023 Oct;17(5):1480-1487. doi: 10.1007/s11764-022-01164-5. Epub 2022 May 6.
Ostomies due to cancer surgery impose complex and enduring care challenges that necessitate cancer survivors" self-management. The objective of this analysis is to evaluate ostomates' self- management goals using a qualitative approach.
A multi-site randomized controlled trial testing the Ostomy Self-Management Training program (OSMT) was delivered via telehealth to a group of cancer survivors with an ostomy randomized to either the OSMT program with goal setting or usual care (UC), without goal setting. Goals were classified by type and frequency according to a modified City of Hope Health-Related Quality of Life framework (physical, psychological, social, spiritual, ostomy-specific, and healthcare quality domains), using a directed and systematic content analysis approach.
The 524 self-management goals analyzed by domain frequencies physical (29.4%), ostomy specific (29.0%) and social well-being (25.0%) were predominant. Managing other health issues (7.6%), psychological issues (6.0%), and spiritual well-being issues (3.0%) were next. Common self-management themes were ostomy care independence (87.5%), handling cancer-related issues (62.5%), achieving acceptance (56.2%), resuming physical activity (43.0%), and maintaining fluid/diet balance (43.0%).
DISCUSSION/CONCLUSION: Goal-setting offers insights into self-management concerns of cancer survivors with ostomies. Results demonstrate the broad aspects of self-management ostomates face.
Self-management training with patient goal-setting may be used to help ostomates with cancer and their health care providers identify areas for needed education and support.
癌症手术导致的造口术带来了复杂且持久的护理挑战,这需要癌症幸存者进行自我管理。本分析的目的是使用定性方法评估造口者的自我管理目标。
一项多地点随机对照试验,通过远程医疗向一组患有造口术的癌症幸存者提供造口自我管理培训计划(OSMT),这些患者被随机分为 OSMT 计划(有目标设定)或常规护理(UC,无目标设定)。目标根据类型和频率进行分类,依据的是一个经过改良的希望之城健康相关生活质量框架(身体、心理、社会、精神、造口术特定和医疗保健质量领域),使用定向和系统的内容分析方法。
通过域频率分析,共分析了 524 个自我管理目标,其中身体(29.4%)、造口术特定(29.0%)和社会幸福感(25.0%)占主导地位。其次是管理其他健康问题(7.6%)、心理问题(6.0%)和精神幸福感问题(3.0%)。常见的自我管理主题包括造口护理独立性(87.5%)、处理癌症相关问题(62.5%)、实现接受(56.2%)、恢复体力活动(43.0%)和保持液体/饮食平衡(43.0%)。
讨论/结论:目标设定提供了对有造口术的癌症幸存者自我管理关注点的深入了解。结果表明了造口者面临的广泛的自我管理方面。
带患者目标设定的自我管理培训可能有助于癌症造口患者及其医疗保健提供者确定需要教育和支持的领域。