肺癌患者病耻感经历的Meta整合

doi:10.3761/j.issn.1672-9234.2024.02.017

摘要/Abstract

摘要：

目的系统总结肺癌患者在生活及就医过程中的病耻感经历，为降低肺癌患者病耻感提供参考。方法检索Cochrane Library、PubMed、CINAHL、Web of Science、EBSCO、Embase、Medline、PsycINFO、中国知网、万方、中国生物医学数据库、维普等数据库中从建库至2023年2月收录的关于肺癌患者病耻感的质性研究。采用2016版澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献进行质量评价，采用汇集性整合的方法对结果进行整合分析。结果共纳入11篇文献，提炼出20个研究结果，归纳形成7个类别，得出3个整合结果：面临内在贬低和公众歧视的困境、产生多方面的不良影响、采取多样性的应对。结论本研究探索了肺癌患者病耻感相关经历，发现病耻感对患者产生较大负面影响，不同肺癌患者有消极或积极的病耻感应对经历。临床护士可借鉴肺癌患者有效的积极应对策略进行干预，以降低或消除其病耻感。

关键词: 肺癌, 病耻感, 质性研究, Meta整合

Abstract:

Objective To summarize the stigma experience of lung cancer patients in life and medical treatment systematically，so as to provide evidence for target interventions. Methods Cochrane Library，PubMed，CINAHL，Web of Science，EBSCO，Embase，Medline，PsycINFO，CNKI，Wanfang，CBM and VIP were searched from the establishment to February 2023. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research（2016 edition） was used to evaluate the quality of the included articles，and then the results were integrated by meta-synthesis. Results A total of 11 studies were included，and 20 results were extracted which can be classified into seven new categories. Finally，three integrated results were summarized：1） confronting internal self-deprecation and public discrimination，2） resulting in a variety of adverse impacts，and 3） adopting diverse coping strategies. Conclusion This study explored the experiences related to stigma in patients with lung cancer. Stigma has a great negative impact on patients，and different lung cancer patients have negative or positive experiences of coping with stigma. Clinical nurses can learn from the effective positive coping strategies of lung cancer patients to intervene to eliminate their stigma.

Key words: Lung cancer, Stigma, Qualitative research, Meta synthesis

王蕊, 隋鸿平, 李婷婷, 姜桐桐, 夏云龙, 史铁英. 肺癌患者病耻感经历的Meta整合[J]. 中华护理教育, 2024, 21(2): 231-236.

WANG Rui, SUI Hongping, LI Tingting, JIANG Tongtong, XIA Yunlong, SHI Tieying. The stigma experience of lung cancer patients：a meta-synthesis of qualitative studies[J]. Chinese Journal of Nursing Education, 2024, 21(2): 231-236.

图/表 3

参考文献 26

[1]	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality world-wide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. doi: 10.3322/caac.v71.3
[2]	Major B, O’Brien LT. The social psychology of stigma[J]. Annu Rev Psychol, 2005, 56:393-421. pmid: 15709941
[3]	于媛, 刘均娥. 肺癌患者病耻感的研究进展[J]. 中华护理杂志, 2014, 49(11):1386-1390.
[4]	贺婧, 陈诗皓, 肖鹏. 肺癌患者病耻感的影响因素及干预研究进展[J]. 中华现代护理杂志, 2022, 28(14):1956-1960.
	He J, Chen SH, Xiao P. Research progress on influencing factors and intervention of stigma in patients with lung cancer[J]. Chin J Mod Nurs, 2022, 28(14):1956-1960.
[5]	Maguire R, Lewis L, Kotronoulas G, et al. Lung cancer stigma:a concept with consequences for patients[J]. Cancer Rep (Hobo-ken), 2019, 2(5):e1201.
[6]	Rankin NM, McWilliams A, Marshall HM. Lung cancer screening implementation:complexities and priorities[J]. Respirology, 2020, 25(Suppl 2):5-23. doi: 10.1111/resp.v25.S2
[7]	Williamson TJ, Kwon DM, Riley KE, et al. Lung cancer stigma:does smoking history matter?[J]. Ann Behav Med, 2020, 54(7):535-540. doi: 10.1093/abm/kaz063 pmid: 31942920
[8]	Webb LA, McDonnell KK, Adams SA, et al. Exploring stigma among lung cancer survivors:a scoping literature review[J]. Oncol Nurs Forum, 2019, 46(4):402-418.
[9]	胡雁. 如何开展质性研究的系统评价和Meta整合[J]. 上海护理, 2020, 20(7):1-5.
[10]	Purohit C, Rabari R. Stigma, shame, and blame experienced by patients with lung cancer:a qualitative study[J]. IP Ind J Immu Resp Med, 2020, 5(2):75-77.
[11]	Occhipinti S, Dunn J, O’Connell DL, et al. Lung cancer stigma across the social network:patient and caregiver perspectives[J]. J Thorac Oncol, 2018, 13(10):1443-1453. doi: S1556-0864(18)30766-4 pmid: 29981928
[12]	Rowland C, Danson SJ, Rowe R, et al. Quality of life,support and smoking in advanced lung cancer patients:a qualitative study[J]. BMJ Support Palliat Care, 2016, 6(1):35-42. doi: 10.1136/bmjspcare-2013-000589
[13]	Rohan EA, Boehm J, Allen KG, et al. In their own words:a qualitative study of the psychosocial concerns of posttreat-ment and long-term lung cancer survivors[J]. J Psychosoc Oncol, 2016, 34(3):169-183. doi: 10.1080/07347332.2015.1129010
[14]	Liu HX, Yang QQ, Narsavage GL, et al. Coping with stigma:the experiences of Chinese patients living with lung cancer[J]. Springerplus, 2016, 5(1):1790. doi: 10.1186/s40064-016-3486-5
[15]	王黎, 于媛, 张娜, 等. 肺癌患者病耻感体验的质性研究[J]. 中华现代护理杂志, 2016(30):4358-4362.
	Wang L, Yu Y, Zhang N, et al. Qualitative research of health-related stigma experience in patients with lung cancer[J]. Mod Nurs, 2016(30):4358-4362.
[16]	Scott N, Crane M, Lafontaine M, et al. Stigma as a barrier to diagnosis of lung cancer:patient and general practitioner perspectives[J]. Prim Health Care Res Dev, 2015, 16(6):618-622. doi: 10.1017/S1463423615000043
[17]	Lehto RH. Patient views on smoking,lung cancer,and stigma:a focus group perspective[J]. Eur J Oncol Nurs, 2014, 18(3):316-322. doi: 10.1016/j.ejon.2014.02.003
[18]	Brown C, Cataldo J. Explorations of lung cancer stigma for female long-term survivors[J]. Nurs Inq, 2013, 20(4):352-362. doi: 10.1111/nin.12024 pmid: 23414179
[19]	Tod AM, Craven J, Allmark P. Diagnostic delay in lung cancer:a qualitative study[J]. J Adv Nurs, 2008, 61(3):336-343. doi: 10.1111/jan.2008.61.issue-3
[20]	Chapple A, Ziebland S, McPherson A. Stigma,shame,and blame experienced by patients with lung cancer:qualitative study[J]. BMJ, 2004, 328(7454):1470. doi: 10.1136/bmj.38111.639734.7C
[21]	Munn Z, Porritt K, Lockwood C, et al. Establishing confidence in the output of qualitative research synthesis:the ConQual approach[J]. BMC Med Res Methodol, 2014, 14:108. doi: 10.1186/1471-2288-14-108
[22]	靳英辉, 高维杰, 李艳, 等. 质性研究证据评价及其循证转化的研究进展[J]. 中国循证医学杂志, 2015, 15(12):1458-1464.
	Jin YH, Gao WJ, Li Y, et al. Advances in quality evaluation and transformation of evidence from qualitative research[J]. Chin J Evid Based Med, 2015, 15(12):1458-1464.
[23]	Corrigan PW, Watson AC, Ottati V. From whence comes mental illness stigma?[J]. Int J Soc Psychiatry, 2003, 49(2):142-157. doi: 10.1177/0020764003049002007
[24]	Ernst J, Mehnert A, Dieta A, et al. Perceived stigmatization and its impact on quality of life-results from a large register-based study including breast,colon,prostate and lung cancer patients[J]. BMC Cancer, 2017, 17(1):741. doi: 10.1186/s12885-017-3742-2 pmid: 29121876
[25]	任志玲. 肺癌患者病耻感与应对方式、社会支持及生活质量相关性及路径分析[D]. 南宁: 广西医科大学, 2019.
[26]	Shen MJ, Hamann HA, Thomas AJ, et al. Association between patient-provider communication and lung cancer stigma[J]. Support Care Cancer, 2016, 24(5):2093-2099. doi: 10.1007/s00520-015-3014-0 pmid: 26553030