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利用同伴叙事支持促进癌症幸存者重返工作岗位:一项行动研究的方案研究

Using peer narrative support to promote return to work for cancer survivors: a protocol study of action research.

作者信息

Que Wenqian, Hu Xiaoyun, Wu Tingting, Zhang Haiyin, Shi Yue, Zhao Jingyi, Su Xiaoqin, Kuai Benxin, Guo Yujie

机构信息

School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, 226001, China.

Qidong People's Hospital/Affliated Qidong Hospital of Nantong University, Nantong, Jiangsu, 226001, China.

出版信息

Arch Public Health. 2025 Jan 23;83(1):21. doi: 10.1186/s13690-024-01498-9.

DOI:10.1186/s13690-024-01498-9
PMID:39849658
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11755956/
Abstract

BACKGROUND

Chinese cancer survivors are not doing well in returning to work. Peer support, as an external coping resource to help cancer survivors return to work, brings together members of the lay community with similar stressors or problems for mutual support. Peer volunteers have not received systematic training, so inappropriate language in the support process can often cause secondary damage to both the peer and the cancer survivor. High-quality narrative support can help both parties gain positive meaning in communication. Therefore, we draw on narrative-related theoretical techniques to construct a model of peer narrative support to facilitate cancer survivors' return to work.

METHODS

This study is a participatory action research, including three phases: (i) Construction: Construct a peer narrative support model through literature review, theoretical research, and expert meetings. A peer narrative competence training program and a peer narrative support implementation program are constructed on this basis. (ii) Intervention: Firstly, two rounds of training actions will be carried out for 8 weeks. Second, after the peers have passed the training assessment, cancer survivors will be recruited to carry out two rounds of peer narrative support for six months. The model framework will be revised in conjunction with observation and reflection during the action. (iii) Evaluation: A combination of quantitative and qualitative methods will be used to assess the feasibility and scientific validity of the peer narrative support model and to evaluate the effectiveness of the intervention. The research methods used include theoretical research, literature review, expert meeting method, participatory observation method, interview method, and questionnaire survey method.

DISCUSSION

China currently has cancer rehabilitation associations in most provinces, cities, and counties, and peer volunteers in these organisations use their personal experience to help other cancer patients. Currently, the content of their help is mostly limited to disease recovery and financial condolences, and there is a lack of scientific training for peer volunteers. This study aims to help patients cope with their suffering and eventually return to work by narrating the stories of role models. The narrative support covers three aspects: focusing on recovery, rebuilding effectiveness, and adjusting planning. In addition, this study relies on the methodology of action research to develop a peer narrative support model, training program, and implementation plan, which are more applicable to the national context of peer support for cancer patients in China. This will provide scientific guidance for the Chinese Cancer Rehabilitation Association to develop peer narrative support and guide cancer survivors back to work.

TRIAL REGISTRATION

This study has been registered at the Chinese Clinical Trial Registry (Registration number ChiCTR2300068403) on Feb 17, 2023. (Retrospectively registered) https://www.chictr.org.cn/bin/project/edit?pid=183766 .

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/705b/11755956/ce09b0fe1e35/13690_2024_1498_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/705b/11755956/e7087a38cd33/13690_2024_1498_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/705b/11755956/ce09b0fe1e35/13690_2024_1498_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/705b/11755956/e7087a38cd33/13690_2024_1498_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/705b/11755956/ce09b0fe1e35/13690_2024_1498_Fig2_HTML.jpg
摘要

背景

中国癌症幸存者在重返工作岗位方面情况不佳。同伴支持作为一种帮助癌症幸存者重返工作岗位的外部应对资源,将具有相似压力源或问题的普通社区成员聚集在一起相互支持。同伴志愿者未接受过系统培训,因此在支持过程中不恰当的语言往往会对同伴和癌症幸存者双方造成二次伤害。高质量的叙事支持有助于双方在交流中获得积极意义。因此,我们借鉴与叙事相关的理论技术构建同伴叙事支持模型,以促进癌症幸存者重返工作岗位。

方法

本研究为参与式行动研究,包括三个阶段:(i)构建:通过文献综述、理论研究和专家会议构建同伴叙事支持模型。在此基础上构建同伴叙事能力培训方案和同伴叙事支持实施方案。(ii)干预:首先,开展为期8周的两轮培训行动。其次,同伴通过培训评估后,招募癌症幸存者开展为期6个月的两轮同伴叙事支持。结合行动中的观察与反思对模型框架进行修订。(iii)评估:采用定量与定性相结合的方法评估同伴叙事支持模型的可行性和科学有效性,并评估干预效果。使用的研究方法包括理论研究、文献综述、专家会议法、参与式观察法、访谈法和问卷调查法。

讨论

中国目前在大多数省、市、县都设有癌症康复协会,这些组织中的同伴志愿者利用自身经历帮助其他癌症患者。目前,他们的帮助内容大多局限于疾病康复和经济慰问,对同伴志愿者缺乏科学培训。本研究旨在通过讲述榜样故事帮助患者应对痛苦并最终重返工作岗位。叙事支持涵盖三个方面:关注康复、重建效能和调整规划。此外,本研究依托行动研究方法开发同伴叙事支持模型、培训方案和实施方案,更适用于中国癌症患者同伴支持的国情。这将为中国癌症康复协会开展同伴叙事支持提供科学指导,引导癌症幸存者重返工作岗位。

试验注册

本研究于2023年2月17日在中国临床试验注册中心注册(注册号ChiCTR2300068403)。(追溯注册)https://www.chictr.org.cn/bin/project/edit?pid=183766 。

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