School of Nursing, Qingdao University, Qingdao, Shandong, China.
Department of Thoracic Surgery, Linyi Cancer Hospital, Linyi, Shandong, China.
Semin Oncol Nurs. 2022 Dec;38(6):151352. doi: 10.1016/j.soncn.2022.151352. Epub 2022 Oct 14.
The introduction of oral-targeted therapy for cancer improves survival while adherence also presents as a challenge to patients. Current studies on oral anticancer agents are primarily limited to patients from developed countries with breast cancer and chronic myeloid leukemia receiving oral chemotherapy and hormonal therapy. This study explored experience of oral-targeted therapy adherence among Chinese patients with nonsmall cell lung cancer and its contributing factors by using a qualitative research.
Semi-structured interviews with 16 patients and 7 family caregivers at a tertiary tumor hospital in China were conducted to understand their experience and perceptions of oral-targeted therapy. Thematic analysis was applied to generate the themes and to identify underlying factors associated with the adherence.
The lung cancer survivors struggled with ambivalence between survival and relief during taking targeted anticancer medication and showed diverse models of nonadherence, including intentionally or unintentionally intermittent medication and overadherence. Three main themes were identified: (1) cancer-related distresses, (2) inadequate social support, and (3) forgetfulness, together with seven subthemes, representing factors impeding patients' medication adherence. The themes demonstrate complicated and interrelated factors from personal, interpersonal, sociocultural, and structural forces contributing to patients' poor adherence.
The findings suggest the imperativeness of reinforcing community- or home-based oral-targeted medication management in which nurses play a principal role to implement strategies of patient education, symptom management, reminder prompts, and monitoring to improve adherence.
癌症口服靶向治疗的引入提高了患者的生存率，但同时也给患者带来了依从性挑战。目前关于口服抗癌药物的研究主要局限于来自发达国家的乳腺癌和慢性髓性白血病患者，他们接受口服化疗和激素治疗。本研究通过定性研究探讨了中国非小细胞肺癌患者口服靶向治疗依从性及其影响因素的经验。
在中国一家三级肿瘤医院对 16 名患者和 7 名家庭照顾者进行了半结构式访谈，以了解他们对口服靶向治疗的体验和看法。采用主题分析生成主题，并确定与依从性相关的潜在因素。
肺癌幸存者在服用靶向抗癌药物时，在生存和缓解之间挣扎，表现出不同的不依从模式，包括有意或无意的间歇性用药和过度依从。确定了三个主要主题：（1）癌症相关痛苦；（2）社会支持不足；（3）健忘，以及七个子主题，代表了阻碍患者用药依从性的因素。这些主题表明，个人、人际、社会文化和结构因素相互交织，共同导致患者依从性差。
研究结果表明，加强社区或家庭为基础的口服靶向药物管理势在必行，护士在其中发挥主要作用，实施患者教育、症状管理、提醒提示和监测策略，以提高依从性。
