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小肠神经内分泌肿瘤患者的经历与基本护理需求——一项外科背景下的访谈研究

Experiences and Fundamental Care Needs in Patients With Small Intestinal Neuroendocrine Tumours-An Interview Study in a Surgical Context.

作者信息

Olsson Frida, Jangland Eva, Edfeldt Katarina

机构信息

Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

出版信息

J Adv Nurs. 2025 Apr;81(4):2061-2071. doi: 10.1111/jan.16441. Epub 2024 Sep 11.

Abstract

AIMS

The study aimed to describe patients' fundamental care needs and their experiences of nursing care, throughout surgical treatment of small intestinal neuroendocrine tumours.

DESIGN

A qualitative descriptive study was performed.

METHODS

Patients' interviews (n = 19) were conducted in Sweden from May 2021 to January 2022 and analysed using directed qualitative content analysis guided by the Fundamentals of Care framework.

RESULTS

The results are presented in three descriptive categories chronologically throughout the care chain. In the preoperative phase of care, the category was 'Feeling safe but lonely and frightened, and struggling with existential thoughts'; experiences in the postoperative phase of care resulted in the category 'Feeling cared for but suffering from physical symptoms and feelings of loneliness'; and the category in the discharge phase was 'Lacking self-care information and feeling worried about the future'.

CONCLUSION

There were deficiencies in the delivery of fundamental care for patients with a rare tumour diagnosis throughout surgical treatment. Nursing care is mostly task focused and fragmented, and there is a lack of psychosocial and relational care across the care chain. Registered nurses and nursing managers need to take responsibility for their leadership in nursing care to fulfil patients' fundamental care needs. The Fundamentals of Care framework could be used for work improvements to include all aspects of nursing care.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: High-quality nursing care is needed throughout the care chain, including self-care after discharge, for patients with this rare tumour diagnosis. A higher awareness of patients' experiences and the importance of psychosocial support is warranted. Registered nurses and nursing managers must revise and improve routines to support patients' psychosocial needs. Registered nurses need to take responsibility for their leadership in nursing care to fulfil patients' fundamental care needs.

IMPACT

What problem did the study address? This study highlights patients' fundamental care needs and experiences of nursing care throughout surgical treatment of small intestinal neuroendocrine tumours. What were the main findings? There are deficiencies in fulfilling patients' fundamental care needs across the care chain and in all dimensions of the Fundamental of Care framework throughout surgical treatment of small intestinal neuroendocrine tumours. Patients struggled with loneliness and existential thoughts, as well as worries about the future. Patients experienced a lack of information about plans for the day, self-care, and follow-ups. Where and on whom will the research have an impact? For clinicians to develop an understanding of, and improve, fundamental care needs for patients with small intestinal neuroendocrine tumours in a surgical context. For registered nurses to understand the importance of their leadership and nursing responsibility to fulfil fundamental care needs.

REPORTING METHOD

The consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

PATIENT CONTRIBUTION

The patients shared their experiences during the interviews, which has contributed to a deeper knowledge and understanding of the phenomena under study.

摘要

目的

本研究旨在描述小肠神经内分泌肿瘤手术治疗全过程中患者的基本护理需求及其护理体验。

设计

进行了一项定性描述性研究。

方法

2021年5月至2022年1月在瑞典对患者进行了访谈(n = 19),并采用以护理基本框架为指导的定向定性内容分析法进行分析。

结果

结果按护理链的时间顺序分为三个描述性类别呈现。在护理的术前阶段,类别为“感到安全但孤独、恐惧,并与生存相关的想法作斗争”;术后护理阶段的体验产生了“感到得到照顾但遭受身体症状和孤独感”这一类别;出院阶段的类别为“缺乏自我护理信息并对未来感到担忧”。

结论

在小肠神经内分泌肿瘤的整个手术治疗过程中,针对罕见肿瘤诊断患者的基本护理存在不足。护理工作大多以任务为重点且分散,护理链中缺乏心理社会和关系性护理。注册护士和护理管理者需要对其在护理工作中的领导责任负责,以满足患者的基本护理需求。护理基本框架可用于改进工作,以涵盖护理的各个方面。

对专业和/或患者护理的启示:对于患有这种罕见肿瘤诊断的患者,在整个护理链中都需要高质量的护理,包括出院后的自我护理。有必要提高对患者体验以及心理社会支持重要性的认识。注册护士和护理管理者必须修订和改进常规做法,以支持患者的心理社会需求。注册护士需要对其在护理工作中的领导责任负责,以满足患者的基本护理需求。

影响

该研究解决了什么问题?本研究突出了小肠神经内分泌肿瘤手术治疗全过程中患者的基本护理需求及其护理体验。主要发现是什么?在小肠神经内分泌肿瘤的整个手术治疗过程中,在护理链以及护理基本框架的所有维度上,满足患者基本护理需求都存在不足。患者与孤独和生存相关的想法作斗争,以及对未来感到担忧。患者缺乏关于日常计划、自我护理和随访的信息。该研究将对何处及何人产生影响?让临床医生了解并改善小肠神经内分泌肿瘤手术患者的基本护理需求。让注册护士理解其领导作用和护理责任对于满足基本护理需求的重要性。

报告方法

定性研究报告的统一标准(COREQ):一份用于访谈和焦点小组的32项清单。

患者贡献

患者在访谈中分享了他们的经历,这有助于更深入地了解和认识所研究的现象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f2b/11896833/e09c30d94a1c/JAN-81-2061-g002.jpg

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