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应对家庭功能变化:对面临晚期肺癌的夫妻的定性研究。

Coping with family function changes: A qualitative study of couples facing advanced lung cancer.

作者信息

Pan Xiaoting, Yang Yingzi, Chen Xinxin, Huang Weichao, Ye Junyan, Huang Ying, Li Yumei

机构信息

School of Medicine, Tongji University, Shanghai, China.

Department of Nursing, Shanghai Health and Medical Center, Wuxi, China.

出版信息

Asia Pac J Oncol Nurs. 2024 May 10;11(7):100504. doi: 10.1016/j.apjon.2024.100504. eCollection 2024 Jul.

Abstract

OBJECTIVE

This study aimed to explore the experiences of couples with advanced lung cancer in coping with changes in their family functioning.

METHODS

This study included patients with advanced lung disease and their spouses who were hospitalized in a tertiary hospital in Shanghai, China. Data were collected through interviews that focused on three key areas: (1) patient coping, (2) spousal coping, and (3) dyadic coping. Semi-structured qualitative interviews were conducted in Chinese and analyzed using Braun-Clarke thematic analysis.

RESULTS

A total of 15 couples participated in the study (12 male and 3 female patients). The average age of the patients was 63.73 years, and that of their partners was 63.20 years. Marriage duration ranged from 25 to 53 years. Three distinct themes emerged from the data: individual patient coping was expressed in four areas: struggle, acceptance of reality, cherishing the present and regaining hope, and rebuilding family life; spousal coping was expressed in three areas: acceptance and understanding of the patient, providing active support, and adjusting roles and sharing of family responsibilities; and dyadic coping was expressed in three areas: cognitive consistency of changes in family functioning, stress communication, and family adjustment and adaptation based on shared cognition. A relationship diagram of patients with advanced lung cancer and their spouses in coping with post-cancer changes in family functioning was constructed.

CONCLUSIONS

Post-cancer coping with changes in family functioning in couples with advanced lung cancer is a continuous developmental and gradual evolutionary process, and there is a close relationship between the two that influences each other. Early assistance for couples to form consistent cognition and communicate effectively with the stress caused by the disease can help improve the family functioning of both partners and, in turn, improve the quality of life of patients. Therefore, it is recommended that clinicians conduct family- or couple-centered intervention studies aimed at improving the post-cancer quality of life of patients with advanced lung cancer.

摘要

目的

本研究旨在探讨晚期肺癌患者夫妇应对家庭功能变化的经历。

方法

本研究纳入了在中国上海一家三级医院住院的晚期肺病患者及其配偶。通过聚焦三个关键领域的访谈收集数据:(1)患者应对,(2)配偶应对,以及(3)二元应对。采用中文进行半结构化定性访谈,并使用布劳恩 - 克拉克主题分析法进行分析。

结果

共有15对夫妇参与了本研究(12名男性患者和3名女性患者)。患者的平均年龄为63.73岁,其配偶的平均年龄为63.20岁。婚姻持续时间为25至53年。数据中出现了三个不同的主题:个体患者应对体现在四个方面:挣扎、接受现实、珍惜当下与重拾希望以及重建家庭生活;配偶应对体现在三个方面:接受和理解患者、提供积极支持以及调整角色和分担家庭责任;二元应对体现在三个方面:家庭功能变化的认知一致性、压力沟通以及基于共同认知的家庭调整与适应。构建了晚期肺癌患者及其配偶应对癌症后家庭功能变化的关系图。

结论

晚期肺癌患者夫妇应对癌症后家庭功能变化是一个持续发展和逐渐演变的过程,两者之间存在密切关系且相互影响较早地帮助夫妇形成一致认知并就疾病所致压力进行有效沟通,有助于改善双方的家庭功能,进而提高患者的生活质量。因此,建议临床医生开展以家庭或夫妇为中心的干预研究,旨在提高晚期肺癌患者癌症后的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcb7/11245901/b24bca300166/gr1.jpg

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