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马来西亚晚期癌症患者生活体验和需求的定性研究:差距与前进的步骤。

A qualitative study of lived experiences and needs of advanced cancer patients in Malaysia: Gaps and steps forward.

机构信息

School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.

Hospis Malaysia, Kuala Lumpur, Malaysia.

出版信息

Qual Life Res. 2023 Aug;32(8):2391-2402. doi: 10.1007/s11136-023-03401-5. Epub 2023 Mar 24.

Abstract

PURPOSE

Due to the high burden of cancer-related suffering, it is paramount to understand the gaps in cancer care that lead to suffering. Advanced cancer patients have unmet needs and challenges that differ from those with early-stage cancer due to the rapid disease progression. By exploring advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects, this study aims to identify gaps in the Malaysian health system and propose contextualised measures to improve cancer care.

METHODS

Semi-structured, in-depth interviews were conducted to explore advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects. The interviews were then transcribed and coded. Themes were developed from the codes using iterative thematic approach.

RESULTS

The lived experiences and needs of nineteen patients converged into four major themes: disruption to daily lives, psychosocial and spiritual support system, information needs, and financial needs. This study described predominantly how cancer impacted patients' lives and livelihood, how patients coped with their psychological conditions after diagnosis, the need for effective communication and trust in a multicultural society, and how finance affected access to and experience of cancer care.

CONCLUSION

Advanced cancer patients had different needs beyond receiving medical treatments. A concerted effort is required from clinicians, allied health professionals, social workers, support groups, and family members to understand and fulfil these needs.

摘要

目的

由于癌症相关痛苦负担沉重,了解导致痛苦的癌症护理差距至关重要。晚期癌症患者的需求和挑战与早期癌症患者不同,因为疾病进展迅速。通过探讨晚期癌症患者在身体、心理、社会和精神方面的生活体验和需求,本研究旨在确定马来西亚卫生系统中的差距,并提出切合实际的措施来改善癌症护理。

方法

采用半结构式深入访谈法,从身体、心理、社会和精神方面探讨晚期癌症患者的生活体验和需求。访谈内容随后进行转录和编码。使用迭代主题方法从代码中开发主题。

结果

19 名患者的生活体验和需求集中在四个主要主题上:日常生活的中断、心理社会和精神支持系统、信息需求和财务需求。本研究主要描述了癌症如何影响患者的生活和生计、患者在诊断后如何应对心理状况、在多元文化社会中进行有效沟通和建立信任的必要性,以及财务状况如何影响癌症护理的获得和体验。

结论

晚期癌症患者除了接受医疗治疗外,还有其他不同的需求。临床医生、辅助医疗专业人员、社会工作者、支持团体和家庭成员需要共同努力,了解和满足这些需求。

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本文引用的文献

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A systematic review of financial toxicity among cancer patients in China.中国癌症患者经济毒性的系统评价。
Asia Pac J Oncol Nurs. 2022 Apr 27;9(8):100071. doi: 10.1016/j.apjon.2022.04.010. eCollection 2022 Aug.
5
Willingness-to-pay for cancer treatment and outcome: a systematic review.癌症治疗和结局的支付意愿:系统综述。
Eur J Health Econ. 2022 Aug;23(6):1037-1057. doi: 10.1007/s10198-021-01407-9. Epub 2021 Dec 2.
9
The Supportive Care Needs of Cancer Patients: a Systematic Review.癌症患者的支持性护理需求:系统评价。
J Cancer Educ. 2021 Oct;36(5):899-908. doi: 10.1007/s13187-020-01941-9. Epub 2021 Jan 25.

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