鼻咽癌患者治疗过程中的生活体验的定性分析。
A qualitative analysis of patient's lived experience on their treatment journey with nasopharyngeal carcinoma.
发表日期:2023 Apr 21
作者:
Joanne Pui Zhee Ng, Walter Yu Hang Lam, Edmond Ho Nang Pow, Michael G Botelho
来源:
JOURNAL OF DENTISTRY
摘要:
探索和分析接受和康复鼻咽癌(NPC)治疗的患者的观点。共有33名不同治疗阶段的NPC患者参与其中。其中7名正在积极接受治疗,13名处于治疗后立即期,13名属于长期期。根据对文献的回顾,基于结构化问卷对患者进行了采访,涵盖他们治疗旅程的不同阶段。访谈记录并进行了转录,采用主题归纳演绎方法进行了定性数据分析。识别出NPC患者体验的三个主要领域:副作用、心理社会幸福感以及医疗保健工作者的作用和支持。患者体验了口腔、局部和全身性的副作用。口腔副作用(口腔黏膜炎、口干、味觉改变、吞咽困难)是NPC患者经历的最大挑战。在局部,肌肤损伤(脱屑、纤维化、皮肤变黑、发红、瘙痒和颈部肿胀)和脱发在治疗停止后得到解决。治疗引起的全身性副作用与身体虚弱、体重减轻和恶心有关。NPC患者的心理社会福祉受到一系列问题的影响,包括支持(医疗保健工作者和家人)、疼痛管理、功能限制、营养需求、信息水平、情绪和财务状况。诊断、治疗和恢复阶段对NPC患者的影响明显,影响他们的局部、全身和心理健康。家庭和医疗工作人员的作用也对整体治疗经验有影响,他们在促进患者治疗旅程中发挥着关键作用。NPC治疗中的口腔和全身副作用对患者的身体和情感幸福感有重大影响。医疗保健提供者有必要了解这些,以便在患者的治疗旅程和恢复期间理解和支持他们,并有同情心地促进他们的临床治疗。版权所有©2023 Elsevier Ltd.
To explore and analyse the perspective of patients undergoing and recovering from nasopharyngeal carcinoma (NPC) therapy.Thirty-three NPC patients at different stages of treatment were enrolled. Seven were actively undergoing treatment, 13 were immediately post-treatment, and 13 were long-term. Patients were interviewed using a structured questionnaire based on a review of the literature that covered different phases of their treatment journey. The interview was recorded and transcribed for qualitative data analysis using a thematic inductive-deductive approach.Three main domains embracing aspects of NPC patients' experiences were identified; side effects, psychosocial well-being, and the role and support of healthcare workers. Side effects were experienced orally, locally, and systemically. Oral side effects (oral mucositis, xerostomia, altered taste, dysphagia) were the most significant challenge experienced by NPC patients. Locally, skin injury (desquamation, fibrosis, darkening of the skin, erythema, pruritus, and swelling around the neck region) and hair loss, resolved after cessation of therapy. Systemic side effects from the treatment were related to general weakness, weight loss and nausea. The psychosocial well-being of NPC patients was influenced by a range of issues including support (healthcare workers and family), pain management, functional limitations, nutritional needs, perceived level of information, emotion, and finances.NPC patients were significantly impacted based on the diagnosis, treatment and recovery phase affecting them locally, systemically, and psychologically. The role of family and healthcare staff was also influential in the overall treatment experience, and they have key roles to play in facilitating patients along their treatment journey.Oral and general side effects from NPC treatment have significant impact on patients physical and emotional well-being. It is important for healthcare providers to have insights of these so as to understand and support patients during their treatment journey and recovery and be able to empathetically facilitate their clinical management.Copyright © 2023. Published by Elsevier Ltd.