老年人数字诊疗产品使用影响因素的质性研究

目的：探究老年人使用数字诊疗产品的影响因素。方法：采用现象学研究方法对15名社区老年人进行有关数字诊疗产品接受度与使用情况的半结构式深入访谈,访谈资料采用Colaizzi七步分析法进行分析。结果：老年人使用数字诊疗产品主要包括动机产生、行动产生和维持行动3个阶段。需求是动机产生的基础,在动机转变为行动的过程中,个人资源（包括线下医疗途径通畅度、自我效能感）和环境因素（包括子女或亲友的推荐、外界的宣传介绍、他人帮助）是重要影响因素。老年人的使用体验（包括对产品功能效果以及操作难易的感受）会影响后续的使用动机和使用行为。结论：为提升老年人对数字诊疗产品的使用频率,要先了解老年人的需求与使用动机,提供有针对性的推动策略,加强宣传介绍与帮助指导,促使动机转化为行动。为维持老年人的使用行为,要发展适合他们的产品,让其拥有良好的使用体验。     

抑郁障碍患者心理治疗感受的质性研究

探索抑郁障碍患者在心理治疗前后及其过程中的内心体验.使用立意取样法选9倒抑郁患者,深入访谈法收集资料,Colaizzi法分析资料.结果显示:(1)发病前压力大,对心理治疗基本没概念;(2)心理治疗过程中喜忧掺半:既有正性的感受,又有负性的感受;(3)经济压力大;(4)对医院和学校不满;(5)对疾病有痛耻感.因此,社会需要加大心理卫生知识的普及,抑郁障碍患者需要深切的人文关怀,医生应努力为患者减轻病耻感,同时要注意其社会功能的恢复.     

抑郁障碍患者心理治疗感受的质性研究

探索抑郁障碍患者在心理治疗前后及其过程中的内心体验。使用立意取样法选9例抑郁患者,深入访谈法收集资料,Colaizzi法分析资料。结果显示:(1)发病前压力大,对心理治疗基本没概念;(2)心理治疗过程中喜忧掺半:既有正性的感受,又有负性的感受;(3)经济压力大;(4)对医院和学校不满;(5)对疾病有病耻感。因此,社会需要加大心理卫生知识的普及,抑郁障碍患者需要深切的人文关怀,医生应努力为患者减轻病耻感,同时要注意其社会功能的恢复。     

心理学质性研究：历史、现状和展望

心理学质性研究具有漫长的过去,却只有短暂的历史。心理学自诞生起就具有质性研究传统,但被主流所忽视。从组织机构、出版渠道和研究成果方面看,当前国内外心理学质性研究的发展态势暗示质性研究传统正在回归到主流当中。尽管仍存在误解和急功近利等众多问题和困难需要克服,但是心理学质性研究方法在研究复杂心理现象和产生新的概念、新的理论方面展现了潜力。心理学质性研究的复兴正使心理学处于一个多元化转向的阶段。     

A型性格高血压患者心理状况的质性研究

近年来随着生物心理社会医学模式的不断发展,性格与疾病的关系越来越受到人们的重视.本研究综合运用量性和质性研究方法以A型性格高血压患者为研究对象,深入探究他们的心理状况及体验,为其进一步干预策略的形成提供科学依据.     

中青年脑卒中患者创伤后成长质性研究

为深入了解中青年脑卒中患者创伤后成长的真实体验,运用现象学研究方法,选取10例受访者进行深度面对面半结构化访谈,访谈资料采用Colaizzi现象学分析法进行整理分析。提炼主题可归纳为中青年经历脑卒中后的心理痛苦、中青年患者创伤后成长促进因素及中青年患者创伤后成长体验三个部分。中青年脑卒中患者存在创伤后成长这一积极心理体验,为临床心理护理干预提供新的切入点。临床医护人员应关注患者早期创伤反应及压力源,从促进因素入手,激发中青年患者的潜能和力量,充分利用其心理资源以达到身心适宜的状态。     

癌症患者家属选择是否告知患者真实病情的质性研究

在东方或发展中国家,家庭成员得了癌症后,家属通常反对告知患者真实病情。本研究运用质性研究方法对15例癌症患者家属进行深入访谈,探讨癌症患者家属选择是否告知患者真实病情的原因,以其为临床医护人员正确处理癌症病情告知问题提供指导。     

手术室护士职业认同感的质性研究

为了解手术室护士职业认同感的影响因素。采用诠释现象学的方法,对9名手术室注册护士进行面对面深入访谈,运用Colaizzi资料分析方法对资料进行整理分析,提炼主题。影响手术室护士职业认同感的因素有5个主题:工作中得到的人文关怀、对心理和躯体健康的负性影响、薪酬待遇、急救能力和突发事件的应对能力、较高的职业获益感。护士的职业认同感水平有待于进一步提高,管理层应关注手术室护士的职业认同感水平,给予人文关怀,帮助护士进行职业规划并实现,提高职业获益感,提高薪酬待遇,加强对护士身心健康的关爱。     

未婚精神分裂症住院患者父母控制感的质性研究

子女罹患精神分裂症对父母是巨大的冲击,本研究采用解释现象学研究方法,对武汉市某精神卫生中心病房住院治疗的6例未婚精神分裂症患者的父母进行深入访谈、现场录音和笔录,并分析资料。结果显示未婚精神分裂症患者住院期间控制感是父母的核心情绪体验,当失去控制感时,家属会体验到恐惧、焦虑、愤怒、自责,乃至抑郁,而当具有控制感时,家属则会体验到放松。提示专业人员在临床工作中需要考虑增强患者家属的控制感,这样可以促进家属的参与性,乃至增加患者的依从性。     

晚期肺癌化疗患者叙事护理体验的质性研究

对2021年1月～10月15名接受过为期2个月叙事护理的晚期肺癌化疗患者进行半结构式深入访谈,采用内容分析法归纳提炼主题,共归纳出3个主题：疗愈身心（减轻心理痛苦、缓解身体症状）;改变认知理念（对疾病的接纳、对自我意识的强化、自我反思）;提升生命意义感（征服对死亡的恐惧、支持性关系、浸入式意义体验）。在晚期肺癌化疗患者中实施叙事护理,能够从身体-心理-社会-精神四个维度促进患者成长,为肿瘤末期患者生命意义感的提升提供了新视角。

     

慢性病患者及其配偶的二元应对纵向研究进展

通过回顾国内外相关文献,从研究的意义、现状及研究的难点等方面综述慢性病患者及其配偶的二元应对纵向研究进展。结果显示夫妻的二元应对在不同疾病中随着时间推移呈不同的发展趋势;患者和配偶的二元应对方式及应对一致性对双方远期心理健康、关系质量等有重要的预测作用,且可能存在角色、性别、应对方式的差异。国内目前在该方面的研究较少,可借鉴国外研究方法,探究不同疾病背景下夫妻二元应对的发展及其对心理社会适应的预测作用,为制定有针对性的二元干预措施提供指导。

     

乳腺癌患者二元调整的研究进展

通过检索相关文献,对乳腺癌患者二元调整的概念、国内外研究现状、评估工具、影响及干预措施等方面进行综述。探讨了二元调整对乳腺癌患者生理健康、心理健康及认知行为的影响,护理人员可以通过提高患者心理压力应对能力、提升疾病认知和鼓励伴侣参与等干预方式来提升乳腺癌患者的二元调整,并对未来的研究方向提出一些见解,旨在为我国开展乳腺癌患者二元调整的干预研究提供理论参考,以期改善乳腺癌患者的健康结局。

     

癌症患者照顾者对病情告知偏好质性研究的Meta整合

系统评价有关癌症患者照顾者对于病情告知偏好的质性研究,为构建符合家庭需求的病情告知模式提供依据。系统检索相关中英文文献并进行质量评价,运用Meta整合的方法整合结果。共纳入17篇文献,提取出27个研究结果,归纳为6个类别,形成2个整合结果：照顾者对于是否告知癌症患者病情有不同的做法和考量;照顾者期望个性化、委婉、有助于癌症患者维持希望的病情告知模式。医护人员应全面动态评估照顾者的病情告知偏好和患者意愿,共同商讨符合家庭需求的病情告知策略,帮助他们有效沟通和应对。

     

乳腺癌患者的心理状况及相关因素分析

乳腺癌患者常常被各种心理问题所困扰,特别是乳腺癌根治术对女性性特征所带来的严重影响,各种心理问题更为突出。这些心理问题不但影响患者的生活质量,而且影响疾病的发生、发展及转归。本文回顾了患者的个人因素、疾病本身和治疗因素及其他社会心理因素与心理状况的关系,对乳腺癌患者进行心理干预、临床的综合诊治和防治过程提供新思路。     

Family Communication and Genetic Counseling: The Case of Hereditary Breast and Ovarian Cancer

In familial breast/ovarian cancer, the information that the proband is able to supply about other family members is of critical importance for genetic counseling. This frequently requires family communication. Forty-six women attending a cancer genetics clinic were interviewed as part of a longitudinal study. Nearly all reported affected maternal, rather than paternal relatives, which may indicate lack of awareness by women with paternal histories. There was also much more communication among female relatives. Mothers, where they were still alive, were key figures in supplying family information. Although the majority of the sample contacted at least one relative regarding counseling, most named a relative with whom they did not feel able to communicate on this subject. Probands balanced the perceived obligation of passing on information with that of not causing alarm. Communication, both obtaining and giving information, was impeded by adoption, divorce and remarriage, family rifts, and large age gaps between siblings.     

Development of a Communication Aid to Facilitate Risk Communication in Consultations with Unaffected Women from High Risk Breast Cancer Families: A Pilot Study

The literature on risk perception in women from high-risk breast cancer families reveals persistent over-estimation of risk, even after counseling. In this study, a communication aid was designed to facilitate discussion of risk between clinical geneticists and genetic counselors and women from this high-risk population. Method: Stage 1. The aid was developed by an expert panel of clinical geneticists, genetic counselors, psychologists, an epidemiologist, an oncologist, linguists and a consumer. It was guided by the international literature on risk communication and a large multi-centre Australian study of risk communication. The 13 page full-color communication aid used varying formats of words, numbers, graphs and pie-charts to address (a) the woman’s subjective risk; (b) the population risk of breast cancer; c) the risk of inherited breast cancer; (d) the cumulative risk for women with BRCA1 and BRCA2 mutations; (e) family risk factors; (f) the woman’s suitability for genetic testing; (h) screening and management recommendations, and (i) a re-assessment of the woman’s subjective risk. Stage 2: A before–after pilot study of 38 women who were unaffected with breast cancer and were attending four Australian familial cancer clinics was undertaken. Baseline and follow-up questionnaires were completed by 27 women. Outcomes were compared to those observed in 107 similar women undergoing genetic counseling without the communication aid in 2001. Results: The risk communication aid appears to be beneficial; breast cancer genetics knowledge improved in some areas and importantly, risk perceptions improved in the cohort receiving the communication aid. Psychological measures showed no difference in anxiety or depression between the group receiving the communication aid and the comparison cohort. Women and clinicians were very positive about the usefulness of the communication aid as an adjunct to the genetic counseling consultation.     

Partners and Fellow Patients: Two Sources of Emotional Support for Women with Breast Cancer

This study examined the helping process that occurred when 26 breast cancer patients (the disclosers) talked about their illness-related concerns with their partner and, in a separate conversation, with a fellow patient (the volunteer helpers). The conversations were rated by trained observers and by the disclosers in terms of several process and outcome variables. From the observers' perspective, the volunteer helpers were more helpful, empathic, and supportive, less critical, and used more self-disclosure than the partners. Disclosers did not differentiate between the two types of helper, and gave generally high ratings to both conversations. Strengths and weaknesses of each type of helper were identified. Findings are discussed in relation to the literature on formal and informal helping, and implications for training nonprofessional helpers are suggested.     

Knowledge of Breast Cancer Genetics Among Breast Cancer Patients and First-Degree Relatives of Affected Individuals

The cloning of BRCA1, a susceptibility gene for inherited breast cancer, has made genetic screening possible for individuals and families whose medical histories are suggestive of an inherited predisposition to breast cancer. To date, few systematic attempts have been made to determine the level of knowledge about breast cancer genetics among women who are likely to seek BRCA1 screening when it becomes widely available. The present study attempted to assess the general knowledge about BRCA1 mutations in two groups: (1) first-degree relatives (FDRs) of breast cancer patients; and (2) women with a previous diagnosis of breast cancer. A self-administered, thirty-item questionnaire was developed through a pilot study. Ten of the items were objective, factual questions about breast cancer genetics. Responses to these questions were used to generate an overall knowledge score for each respondent. The study population was moderately knowledgeable about breast cancer genetics, with an average score of 5.35 out of 10. Counselors should not underestimate the importance of evaluating each counselee's existing knowledge about breast cancer, which can affect the provision and reception of genetic information. In particular, specific areas of knowledge that may be confusing or misunderstood were identified and these topics are discussed in detail.