晚期肺癌患者的个人价值观、愿望和目标:定性研究

IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES European Journal of Cancer Care Pub Date : 2024-08-09 DOI:10.1155/2024/9987322
Mara König, Anja Siegle, Laura Unsöld, Jan Ole Ludwig, Nicole Deis, Michael Thomas, Regina Poß-Doering, Matthias Villalobos
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引用次数: 0

摘要

目的。针对无法治愈的癌症患者的肿瘤学和姑息治疗指南建议,通过考虑患者的个人价值观、愿望和目标,在生命末期(EOL)为患者提供支持,以促进预先护理计划和以患者为中心的护理决策。然而,如何在临床实践中成功处理和整合个人价值观尚不清楚。本研究旨在从晚期肺癌患者的角度探讨其价值观、愿望和目标。研究方法对晚期肺癌患者进行了半结构化访谈,并逐字记录。采用结构化内容分析法对数据进行分析。在确定主要类别后,以施瓦茨的人类基本价值观理论为理论框架确定价值观。结果如下确定的主要类别是 "医疗护理中的个人"、"现在的生活 "和 "接受现实"。从 "保护 "和 "对改变持开放态度 "两个维度描述了有关医患互动、治疗目标、临终准备和生活目标的价值观。"自我超越 "的价值观主要与照顾亲属的负担有关。总体而言,患者在与医生交流时不愿表达有关个人价值观的信息。结论晚期肺癌患者通过各种方式来确定他们希望并能够影响自己的生活和医疗护理。在这种情况下,不同的价值观以及相关的愿望和目标起着至关重要的作用,医疗服务提供者应加以考虑。在就医过程中不愿意表达个人信息的情况突出表明,医生需要采取积极主动的态度,并加强跨专业合作。该研究已在德国临床试验注册中心注册(DRKS00026993)。
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Personal Values, Wishes, and Goals of Patients with Advanced Lung Cancer: A Qualitative Study

Objective. Oncology and palliative care guidelines for patients with incurable cancer recommend supporting patients at the end of life (EOL) by considering their personal values, wishes, and goals to facilitate decision making in advance care planning and patient-centered care. It is unclear, though, how to successfully address and integrate personal values in clinical practice. The aim of this study was to explore values, wishes, and goals from the perspective of patients with advanced lung cancer. Methods. Semistructured interviews were conducted with patients with advanced lung cancer and transcribed verbatim. The data were analysed using a structured content analysis. After identification of main categories, values were identified using Schwartz’s Theory of Basic Human Values as a theoretical framework. Results. Identified main categories were “the individual in medical care,” “living now,” and “coming to terms.” Values in the dimensions “conservation” and “openness to change” were described concerning patient-physician interaction, therapy goals, preparedness for EOL, and life goals. “Self-transcendence” values mainly related to caring for the burden on relatives. In general, patients showed reluctance in expressing information about personal values when communicating with physicians. Conclusion. Patients with advanced lung cancer engage in various ways to determine how they want and can influence their life and medical care. Different values and the associated wishes and goals play a crucial role in this context and should be taken into account by healthcare providers. The reluctance to express personal information in medical encounters underscores the need for a proactive attitude in physicians and improved interprofessional collaboration. The study was registered in the German register for clinical trials (DRKS00026993).

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来源期刊
European Journal of Cancer Care
European Journal of Cancer Care 医学-康复医学
CiteScore
4.00
自引率
4.80%
发文量
213
审稿时长
3 months
期刊介绍: The European Journal of Cancer Care aims to encourage comprehensive, multiprofessional cancer care across Europe and internationally. It publishes original research reports, literature reviews, guest editorials, letters to the Editor and special features on current issues affecting the care of cancer patients. The Editor welcomes contributions which result from team working or collaboration between different health and social care providers, service users, patient groups and the voluntary sector in the areas of: - Primary, secondary and tertiary care for cancer patients - Multidisciplinary and service-user involvement in cancer care - Rehabilitation, supportive, palliative and end of life care for cancer patients - Policy, service development and healthcare evaluation in cancer care - Psychosocial interventions for patients and family members - International perspectives on cancer care
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