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探索肺癌化疗患者对自我管理的看法:一项使用COM-B模型的定性访谈研究

Exploring the Perspectives of Lung Cancer Chemotherapy Patients on Self-Management: A Qualitative Interview Study Using the COM-B Model.

作者信息

Jia Ruimei, Xie Nina, Li Yue, Zhang Yu

机构信息

School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China.

Department of Internal Medicine, Shaanxi Provincial Cancer Hospital, Xi'an, People's Republic of China.

出版信息

Patient Prefer Adherence. 2025 Jul 12;19:1991-2002. doi: 10.2147/PPA.S522066. eCollection 2025.

Abstract

PURPOSE

Lung cancer chemotherapy patients' self-management behaviors were not satisfactory, especially treatment-related management scored low compared to other management. This study used the capability, opportunity, and motivation-behavior (COM-B) model of behavioral change to explore the perspectives when performing self-management.

METHODS

The study employed semi-structured interviews with 15 patients undergoing chemotherapy for lung cancer. The COM-B model was utilized to guide the development of interview themes and to inform the content analysis methods applied.

RESULTS

The study identified three main themes and eight sub-themes. These included: (1) Competency factors, which encompassed poor management of symptoms and chemotherapy side effects, as well as a lack of patient self-management awareness; (2) Motivational factors, which involved the complexity of the chemotherapy regimen reducing patients' confidence in treatment management, insufficient family support, and a lack of patients' sense of meaning in life with low future expectations; and (3) Opportunity factors, which included financial burden preventing patients from practicing self-management of their disease, lack of access to authoritative knowledge, and limited opportunities to practice self-management.

CONCLUSION

This study proposes targeted interventions based on the research findings, including strengthening symptom management for patients, enhancing patients' knowledge of self-management of health through health training, seminars, and peer exchange meetings, and providing further opportunities for patient self-management by establishing family support networks, community peer support groups, and constructing authoritative health information platforms. By linking social resources, the economic pressure on patients is alleviated. Our research results will contribute to comprehensive self-management for lung cancer chemotherapy patients.

摘要

目的

肺癌化疗患者的自我管理行为不尽人意,尤其是与治疗相关的管理得分相较于其他管理方面较低。本研究运用行为改变的能力、机会和动机-行为(COM-B)模型来探究患者在进行自我管理时的观点。

方法

本研究对15名接受肺癌化疗的患者进行了半结构式访谈。COM-B模型被用于指导访谈主题的制定,并为所应用的内容分析方法提供依据。

结果

该研究确定了三个主要主题和八个子主题。这些主题包括:(1)能力因素,包括对症状和化疗副作用管理不善,以及患者自我管理意识缺乏;(2)动机因素,涉及化疗方案的复杂性降低了患者对治疗管理的信心、家庭支持不足,以及患者生活意义感缺失且未来期望较低;(3)机会因素,包括经济负担使患者无法对自身疾病进行自我管理、缺乏获取权威知识的途径,以及自我管理实践机会有限。

结论

本研究基于研究结果提出了针对性干预措施,包括加强对患者的症状管理、通过健康培训、研讨会和同伴交流会增强患者的健康自我管理知识,以及通过建立家庭支持网络、社区同伴支持小组和构建权威健康信息平台为患者提供更多自我管理机会。通过整合社会资源,减轻患者的经济压力。我们的研究结果将有助于肺癌化疗患者的全面自我管理。

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