上海新冠疫情奥密克戎毒株流行期间接受化疗的癌症患者的持续护理需求:一项定性研究
Continuous care needs in patients with cancer receiving chemotherapy during the recent omicron wave of COVID-19 in Shanghai: A qualitative study.
作者信息
Zhang Jie, Wang Caifeng, Huang Lei, Zhang Jun
机构信息
Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
出版信息
Front Psychol. 2023 Jan 4;13:1067238. doi: 10.3389/fpsyg.2022.1067238. eCollection 2022.
AIMS
This study aimed to investigate the care needs, to clarify the factors affecting the quality of homecare, and to provide reference for constructing a homecare system for patients with cancer receiving chemotherapy during the recent omicron wave of COVID-19 in Shanghai.
METHODS
From March to May 2022 when the omicron wave emerged in Shanghai, 50 consecutive patients who received chemotherapy at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, were enrolled, and underwent face-to-face or telephone-based semi-structured interviews regarding continuous care needs. Some of their homecare-givers, caring nurses, and physicians were also interviewed. The Colaizzi method was used for data analysis.
RESULTS
Fifty patients, 4 homecare-givers, 4 nurses, and 4 physicians were interviewed. Three themes and six subthemes emerged from analysis of the interviews: The first theme was "Disease management needs," including needs for knowledge of managing adverse events associated with chemotherapy, and needs for treatment-related information. Patients expressed most concern about not being able to go to the hospital for blood review and disease evaluation in time due to the outbreak. With the COVID-19 pandemic being ongoing, factors such as pandemic panic, inconvenient medical treatment, and worry about hospital cross-infection might reduce disease management for patients with cancer. The second theme was "Medical needs," including needs for mobile healthcare and needs for medical resources. All interviewees emphasized the importance of mobile healthcare during the COVID-19 pandemic, as access to hospitals was difficult. The third theme was "Spiritual needs," including demands for psychological counseling and intervention, and needs for spiritual care. Patients and homecare-givers commonly lacked a feeling of security and needed communication, encouragement, and reassurance that medical care could be delivered to them, and patients reported that they very much wanted psychological advice.
CONCLUSION
For patients with cancer receiving chemotherapy during the COVID-19 pandemic, continuous care is greatly needed. Medical personnel should strengthen the healthcare education for patients and their caregivers during hospitalization, and further improve the patients' information intake rate through Internet-based digital healthcare methods during homecare, to further meet the information needs of patients after discharge from hospital.
目的
本研究旨在调查护理需求,阐明影响居家护理质量的因素,为上海新冠疫情奥密克戎毒株流行期间构建癌症化疗患者居家护理体系提供参考。
方法
选取2022年3月至5月上海出现奥密克戎毒株期间,在上海交通大学医学院附属瑞金医院接受化疗的50例连续病例,就持续护理需求进行面对面或电话半结构式访谈。同时对部分患者的居家护理人员、责任护士和医生进行访谈。采用Colaizzi法进行数据分析。
结果
共访谈50例患者、4名居家护理人员、4名护士和4名医生。访谈分析得出三个主题和六个子主题:第一个主题是“疾病管理需求”,包括化疗相关不良事件管理知识需求和治疗相关信息需求。患者最担心因疫情无法及时到医院进行血液检查和疾病评估。随着新冠疫情持续,疫情恐慌、就医不便和担心医院交叉感染等因素可能会减少癌症患者的疾病管理。第二个主题是“医疗需求”,包括移动医疗需求和医疗资源需求。所有受访者均强调新冠疫情期间移动医疗的重要性,因为前往医院困难。第三个主题是“精神需求”,包括心理咨询与干预需求和精神关怀需求。患者和居家护理人员普遍缺乏安全感,需要沟通、鼓励和医疗服务能提供给他们的保证,患者表示非常希望得到心理建议。
结论
新冠疫情期间,癌症化疗患者对持续护理的需求迫切。医务人员应在住院期间加强对患者及其照护者的健康教育,并在居家护理期间通过基于互联网的数字医疗方法进一步提高患者的信息获取率,以进一步满足患者出院后的信息需求。