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癌症患儿家长的不确定性:一项概念分析。

Uncertainty of parents due to having children with cancer: A concept analysis.

作者信息

Nurhidayah Ikeu, Nurhaeni Nani, Allenidekania Allenidekania, Gayatri Dewi, Rustina Yeni

机构信息

Postgraduate Program, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.

Pediatric Nursing Department, Faculty of Nursing, Universitas Padjadjaran, Jatinangor, Indonesia.

出版信息

Belitung Nurs J. 2023 Jun 26;9(3):218-226. doi: 10.33546/bnj.2612. eCollection 2023.

Abstract

BACKGROUND

Parents of newly diagnosed cancer children often experience significant concerns about the implications of the diagnosis. They find themselves in challenging decision-making situations, navigating through uncertain conditions following the disclosure. Uncertainty is a prevailing issue in healthcare, yet its interpretation and application within the context of health and nursing practice exhibit multiple meanings and variations.

OBJECTIVE

This study aimed to clarify the concept of parental uncertainty arising from having children with cancer.

METHODS

The concept analysis followed the steps outlined by Walker and Avant. A thorough literature search was conducted using the Embase, CINAHL, and MEDLINE databases to identify articles published between 1980 and 2022.

RESULTS

The literature search yielded 147 articles from various disciplines, including health, nursing, medicine, psycho-oncology, and management. After analysis, 20 articles were selected for inclusion. This study identified four key attributes of parental uncertainty associated with having a child with cancer: (1) emotional disturbance, (2) unpredictability, (3) insufficient information, and (4) problems with decision-making. The antecedents of parental uncertainty encompassed the complexity of the disease, the diagnostic and treatment processes, the hospital environment, communication, and support from credible authorities. The consequences of parental uncertainty included the pursuit of new information, parental adaptability to their role, and parental distress.

CONCLUSION

Understanding the four attributes of parental uncertainty, along with their antecedents and consequences, can facilitate the future development and operational translation of the concept of uncertainty in nursing practice. This concept is valuable in the evidence-based provision of nursing care to parents of children with cancer, enabling comprehensive recognition and assessment of parental uncertainty and the implementation of appropriate interventions that are sensitive to parental experiences. Ultimately, this approach promotes the adaptation of both the child and the parent.

摘要

背景

新确诊癌症儿童的父母常常对诊断结果的影响深感担忧。他们发现自己处于具有挑战性的决策情境中,在诊断结果披露后要应对各种不确定状况。不确定性是医疗保健领域普遍存在的问题,但其在健康和护理实践背景下的解读与应用呈现出多种含义和变化。

目的

本研究旨在阐明因孩子患癌症而产生的父母不确定性这一概念。

方法

概念分析遵循沃克和阿万特所概述的步骤。使用Embase、CINAHL和MEDLINE数据库进行了全面的文献检索,以识别1980年至2022年期间发表的文章。

结果

文献检索从包括健康、护理、医学、心理肿瘤学和管理学等多个学科中获取了147篇文章。经过分析,选择了20篇文章纳入研究。本研究确定了与孩子患癌症相关的父母不确定性的四个关键属性:(1)情绪困扰;(2)不可预测性;(3)信息不足;(4)决策问题。父母不确定性的前因包括疾病的复杂性、诊断和治疗过程、医院环境、沟通以及来自可靠权威机构的支持。父母不确定性的后果包括寻求新信息、父母对自身角色的适应以及父母的痛苦。

结论

理解父母不确定性的四个属性及其前因和后果,有助于未来在护理实践中对不确定性概念的进一步发展和实际应用。这一概念对于为癌症患儿父母提供循证护理具有重要价值,能够全面认识和评估父母的不确定性,并实施对父母经历敏感的适当干预措施。最终,这种方法促进了孩子和父母的适应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20d8/10363973/1b22add9472f/BNJ-9-3-218-g001.jpg

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