中国大陆低收入晚期癌症患者对姑息治疗的偏好：一项定性研究。

Preference for palliative care among low-income advanced cancer patients in Mainland China: a qualitative study.

作者信息

Xie Wenjuan, Huang Hui, Wang Honglian, Luo Na, Chen Hui, Dai Fengling

机构信息

Hefei Ion Medical Center the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.

School of Nursing, Southwest Medical University, Luzhou, China.

出版信息

BMC Palliat Care. 2025 Apr 21;24(1):105. doi: 10.1186/s12904-025-01739-w.

DOI:10.1186/s12904-025-01739-w

PMID:40259291

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12013072/

Abstract

BACKGROUND

Previous studies have highlighted the significant impact of income on access to palliative care. However, few studies have explored the treatment preferences of low-income patients with advanced cancer. These individuals require additional support in terms of palliative care, including financial psychological, spiritual, and social assistance. Therefore, it is essential to conduct more qualitative research with a particular emphasis on the preferences of this population.

AIM

To explore the preference and influencing factors of palliative care among low-income advanced cancer patients in mainland China.

DESIGN

A qualitative study design with a hermeneutic phenomenological approach was used.

METHODS

Semi-structured interviews were conducted with a purposive sample of 23 low-income advanced cancer patients in mainland China. The collected data was analyzed thematically using Giorgi's methodology. The COREQ checklist was used.

RESULTS

Four themes emerged from the analysis: (1) Economic status is crucial for palliative preference selection, which affects the patient's choice of treatment, drugs and whether to continue with palliative care; (2) Family members and medical personnels' support strengthens determination to receive palliative treatment; (3) The Chinese traditional culture of returning to one's roots influences the choice of place of death, surgery and intubation; (4) Patients with advanced cancer tend to prefer the comfort care, refuse to be awakened and agree to sedation to reduce consciousness and thus relieve suffering.

CONCLUSIONS

The preferences of low-income patients with advanced cancer were influenced by economic status, social support, cultural beliefs, and the desire to alleviate suffering. Therefore, medical professionals should be patient with patients, respect them, and provide psychological support. And strengthen patients' economic support by improving medical insurance policies and providing social assistance. At the same time, medical policymakers and clinical staff should respect patients' cultural values and treatment preferences when developing treatment plans.

摘要

背景

先前的研究强调了收入对获得姑息治疗的重大影响。然而，很少有研究探讨低收入晚期癌症患者的治疗偏好。这些患者在姑息治疗方面需要额外的支持，包括经济、心理、精神和社会援助。因此，开展更多侧重于这一人群偏好的定性研究至关重要。

目的

探讨中国大陆低收入晚期癌症患者对姑息治疗的偏好及影响因素。

设计

采用诠释现象学方法的定性研究设计。

方法

对中国大陆23名低收入晚期癌症患者进行了有目的抽样的半结构式访谈。使用 Giorgi 方法对收集到的数据进行主题分析。采用了COREQ清单。

结果

分析得出四个主题：（1）经济状况对姑息治疗偏好的选择至关重要，影响患者对治疗、药物的选择以及是否继续接受姑息治疗；（2）家庭成员和医务人员的支持增强了接受姑息治疗的决心；（3）叶落归根的中国传统文化影响死亡地点、手术和插管的选择；（4）晚期癌症患者倾向于选择舒适护理，拒绝被唤醒并同意使用镇静剂以降低意识从而减轻痛苦。