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血液系统恶性肿瘤患者造血干细胞移植决策冲突:一项描述性定性研究。

Decision-making conflicts regarding hematopoietic stem cell transplantation in patients with hematological neoplasms: A descriptive qualitative study.

机构信息

The School of Nursing, Fujian Medical University, Fujian Province, China.

Department of Hematology, Fujian Medical University Union Hospital, Fujian Province, China.

出版信息

Eur J Oncol Nurs. 2024 Oct;72:102684. doi: 10.1016/j.ejon.2024.102684. Epub 2024 Aug 15.

Abstract

PURPOSE

To explore and understand the conflict in decision-making of hematopoietic stem cell transplantation in patients with hematological neoplasms.

METHODS

A descriptive qualitative study of 16 patients with hematologic neoplasms in the hematology department was conducted between February 2022 and May 2022. Purposive sampling was used to select participants. Face-to-face in-depth personal interviews were performed. Interviews were recorded, transcribed, and coded. This descriptive qualitative study adhered to the COREQ checklist.

RESULTS

All patients indicated difficulties in making decisions regarding hematopoietic stem cell transplantation. Five themes were identified: (1) weighing the pros and cons of HSCT, (2) financial burden versus desire for rebirth, (3) treatment urgency versus being unprepared, (4) saving oneself versus damaging loved ones, and (5) family companionship versus emotional isolation. These themes reflect the contradictions, entanglements, and realistic conflicts in decision-making regarding hematopoietic stem cell transplantation for patients with hematological neoplasms.

CONCLUSIONS

This study identified multiple conflicts of decision-making in patients with hematologic neoplasms regarding decisions on hematopoietic stem cell transplantations. Healthcare workers should provide patients with disease knowledge, doctor-patient and intra-family communication, and access to financial support in order to resolve their conflicts and ultimately help them make the decision that is most optimum for them.

摘要

目的

探讨并理解血液系统恶性肿瘤患者造血干细胞移植决策中的冲突。

方法

2022 年 2 月至 2022 年 5 月,在血液科对 16 例血液系统恶性肿瘤患者进行了一项描述性定性研究。采用目的性抽样选择参与者。采用面对面的深入个人访谈进行访谈。访谈进行了记录、转录和编码。这项描述性定性研究遵循了 COREQ 清单。

结果

所有患者均表示在造血干细胞移植决策方面存在困难。确定了五个主题:(1)权衡 HSCT 的利弊,(2)经济负担与重生的渴望,(3)治疗的紧迫性与准备不足,(4)自救与伤害亲人,以及(5)家庭陪伴与情感孤立。这些主题反映了血液系统恶性肿瘤患者在造血干细胞移植决策方面的矛盾、纠葛和现实冲突。

结论

本研究确定了血液系统恶性肿瘤患者在造血干细胞移植决策方面存在多种决策冲突。医护人员应为患者提供疾病知识、医患和家庭内沟通以及经济支持,以解决冲突,最终帮助他们做出最适合自己的决策。

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