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成人造血干细胞移植出院后症状体验及自我管理策略:一项纵向定性研究。

Symptom experience and self-management strategies of adults undergoing hematopoietic stem cell transplantation after hospital discharge: A longitudinal qualitative study.

机构信息

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

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

出版信息

Eur J Oncol Nurs. 2024 Oct;72:102666. doi: 10.1016/j.ejon.2024.102666. Epub 2024 Jul 11.

DOI:10.1016/j.ejon.2024.102666
PMID:39163757
Abstract

PURPOSE

To explore the symptom experience and self-management strategies of adults undergoing hematopoietic stem cell transplantation after hospital discharge.

METHODS

A longitudinal qualitative study was employed. A heterogeneous sample of 22 patients who underwent hematopoietic stem cell transplantation from August 2022 to April 2023 were included. Semi-structured interviews were conducted at three time points post-discharge and provided a dataset of 56 interviews. The content analysis method was used for manual analysis. This study followed the COREQ checklist.

RESULTS

The data from this study were categorized into four themes and 14 subthemes: (1) complexity and multidimensionality of symptom experience: diversity, dynamism, continuity, relatedness, and functional loading; (2) multiple variations in symptom self-management; (3) barriers to symptom self-management: limited access to information resources, insufficient awareness and skills in symptom self-management, lack of economic and social support, and difficulties in medical visits and reviews; and (4) facilitators of symptom self-management: perceived benefits, experience-driven, and peer experiences.

CONCLUSION

Patients undergoing hematopoietic stem cell transplantation experience multiple and complex symptom experiences after hospital discharge, and their symptom self-management remains challenging. The findings underscore the necessity for healthcare professionals to regularly and consistently evaluate the symptoms and self-management practices of patients undergoing hematopoietic stem cell transplantation and execute focused interventions to alleviate their symptom load and enhance their long-term well-being.

摘要

目的

探讨造血干细胞移植后出院成人的症状体验和自我管理策略。

方法

采用纵向定性研究。纳入 2022 年 8 月至 2023 年 4 月期间接受造血干细胞移植的 22 例异质性患者。在出院后三个时间点进行半结构化访谈,提供了 56 次访谈的数据集。采用内容分析法进行手动分析。本研究遵循 COREQ 清单。

结果

本研究的数据分为四个主题和 14 个次主题:(1)症状体验的复杂性和多维性:多样性、动态性、连续性、相关性和功能负荷;(2)症状自我管理的多种变化;(3)症状自我管理的障碍:信息资源获取有限、症状自我管理意识和技能不足、缺乏经济和社会支持、以及就诊和复查困难;(4)症状自我管理的促进因素:感知益处、经验驱动和同伴经验。

结论

造血干细胞移植后出院的患者经历多种复杂的症状体验,其症状自我管理仍然具有挑战性。研究结果强调了医疗保健专业人员定期和一致地评估造血干细胞移植患者的症状和自我管理实践,并实施有针对性的干预措施以减轻其症状负担并增强其长期幸福感的必要性。

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