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一项探索接受免疫检查点抑制剂治疗晚期肺癌患者体验的定性研究。

A qualitative research exploring the experiences of patients receiving immune checkpoint inhibitors for advanced lung cancer.

机构信息

Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China.

Tianjin Medical University, Tianjin, People's Republic of China.

出版信息

Support Care Cancer. 2023 Jul 29;31(8):498. doi: 10.1007/s00520-023-07965-3.

Abstract

PURPOSES

In patients with advanced lung cancer, immune checkpoint inhibitors (ICIs) dramatically extended survival. We aimed to investigate the experiences of patients with advanced lung cancer who are receiving ICIs, with a focus on perceptions and sentiments on ICIs, to inform future research and clinical care.

METHODS

Patients were recruited from January to July 2022 at Tianjin Medical University Hospital Cancer Institute & Hospital. The method of purposive sampling was used. Patients with stage IV lung cancer who were taking ICIs as a single therapy were recruited. Data were gathered using semi-structured and face-to-face interview. An inductive approach to analysis was used.

RESULTS

Of the 42 eligible patients, 27 were invited, 20 agreed to participate, and ultimately 17 patients completed the interview. A total of 5 themes were extracted: suffered from adverse effects but generally tolerable; focus on survival, hope, and expectation; uncertainty about durability of response and the future; poor knowledge and attitude of ICIs; and financial stress and guilt over family.

CONCLUSION

These findings make an important contribution to healthcare professionals' understanding of what it is like to be a patient with advanced lung cancer who is receiving ICIs. In general, the experience of immunotherapy is different from that of chemotherapy; financial and family pressures and uncertainty issues are likely to be heavier in this population. Oncology specialist nurses should provide tailored education to improve the patient's knowledge of immunotherapy, especially to improve risk awareness of immune-related adverse events and objective prognosis expectations.

摘要

目的

在晚期肺癌患者中,免疫检查点抑制剂(ICI)显著延长了生存期。本研究旨在探讨接受 ICI 治疗的晚期肺癌患者的治疗体验,重点关注患者对 ICI 的看法和感受,以为未来的研究和临床护理提供信息。

方法

本研究于 2022 年 1 月至 7 月在天津医科大学肿瘤医院癌症研究所和医院招募患者。采用目的抽样法招募接受 ICI 单药治疗的 IV 期肺癌患者。采用半结构式和面对面访谈收集数据。采用归纳法进行分析。

结果

在 42 名符合条件的患者中,共邀请了 27 名患者,其中 20 名同意参加,最终有 17 名患者完成了访谈。共提取出 5 个主题:患者经历了不良反应,但总体上可以耐受;关注生存、希望和期待;对反应持久性和未来的不确定性;对 ICI 的认识和态度较差;经济压力和对家庭的愧疚。

结论

这些发现为医护人员了解接受 ICI 治疗的晚期肺癌患者的体验提供了重要参考。一般来说,免疫治疗的体验与化疗不同;该人群可能面临更大的经济和家庭压力以及不确定性问题。肿瘤专科护士应提供有针对性的教育,以提高患者对免疫治疗的认识,特别是提高对免疫相关不良反应的风险意识和客观预后预期。

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