淋巴瘤化疗期患者尊严理解及体验的质性研究

Qualitative Study of Dignity Understanding and Experience in Patients with Lymphoma during Chemotherapy

摘要: 目的：了解老年淋巴瘤化疗期患者对尊严的理解，明确存在的问题，为制定干预方案提供依据。方法：采用半结构式访谈法对新疆某三级甲等肿瘤医院11例老年淋巴瘤化疗患者进行深度访谈，采用质性研究中的Colaizzi现象学七步分析法对访谈资料进行分析并形成主题。结果：经资料分析归纳为3个主题，即患者尊严意义的理解(有自我价值、为他人活下去、无差别对待、尊重和受到他人重视、满足生存需要)损害患者尊严因素(疾病相关因素：对疾病和化疗相关的担忧/恐惧、生理症状的困扰、心理痛苦、病耻感、自豪感/自信心丧失、角色功能缺失、突破隐私界限，社会相关因素：经济负担和家庭支持)、维护患者尊严途径(个体尊严维护途径：进行同类比较、自我封闭、活在当下平和接受、抱有希望、独立自主，社会尊严维护途径：社会支持、医疗服务)。结论：医护人员应实施有效干预从而增加老年淋巴瘤化疗患者尊严体验，发挥多方在照顾情境中的积极作用，培养患者积极情绪，从而促进患者恢复。

Abstract: Objective: To understand the understanding of dignity in elderly patients with lymphoma during chemotherapy, identify the existing problems, and provide evidence for formulating intervention programs. Methods: The semi-structured interview method was used to conduct in-depth interviews on 11 elderly patients with lymphoma undergoing chemotherapy in a tertiary A tumor hospital in Xinjiang. The interview data were analyzed by the seven-step method of Colaizzi phenomenology in the qualitative study and themes were formed. Results: After data analysis, three themes were summarized, namely, the understanding of the meaning of patients’ dignity (having self-worth, living for others, treating without distinction, respecting and being valued by others, and meeting survival needs). Disease and chemotherapy-related worries/fears, distress with physical symptoms, psychological distress, stigma, loss of pride/self-confidence, loss of role function, breach of privacy boundaries, socially relevant factors: financial burden and family support, ways to maintain patient dignity (ways to maintain individual dignity: Comparison, self-isolation, living in the present peaceful acceptance, hope, independence, social dignity maintenance: social support, medical services). Conclusion: Medical staff should implement effective intervention to enhance the dignified experience of elderly patients with lymphoma chemotherapy, play the positive role of multiple parties in the caring situation, cultivate the positive emotions of patients, and promote the recovery of patients.