{"title":"为什么癌症患者决定停止治疗？系统综述与元综合","authors":"Faezeh Abadi, Esmat Nouhi, Mostafa Bijani, Camelia Rohani","doi":"10.1002/cam4.72219","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Discontinuation of treatment by cancer patients is a complex decision driven by many factors that are not yet fully understood. Using a qualitative approach is the best way to explore this complexity in greater depth. Therefore, this study aimed to explore and synthesize the factors that influence the decision-making of cancer patients regarding withdrawal from treatment.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This is a qualitative systematic review and meta-synthesis, conducted using the six-step meta-synthesis method developed by Sandelowski and Barroso in 2007. 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引用次数: 0
摘要
背景：癌症患者停止治疗是一个复杂的决定，受许多尚未完全了解的因素驱动。使用定性方法是更深入地探索这种复杂性的最佳方法。因此，本研究旨在探讨和综合影响癌症患者退出治疗决策的因素。方法采用Sandelowski和Barroso于2007年提出的六步元综合方法，进行定性系统综述和元综合。首先，我们在PubMed、Web of Science、Scopus和CINAHL中进行了全面的系统检索，根据我们的纳入标准确定2000年至2024年间发表的相关研究。随后，采用常规的含量分析方法对定性研究中提取的数据进行分析。最初，348项研究被检索，筛选后，18项研究被纳入meta综合。结果通过综合分析，从177个主要编码中提取出1个主题、2个类别（内生因子和外生因子）和8个小类别。影响退出治疗的因素是：“经济和保险挑战”、“医疗团队的沟通角色”、“文化和社会因素”、“精神和宗教信仰”、“家庭功能”、“个人属性”、“情绪的作用”和“药物副作用”。结论退出治疗的决定是一个多方面的过程，受个人价值观、临床考虑和社会动态的影响。对这些因素的深入了解使医疗保健提供者，特别是护士，能够设计更好的支持方案。
Why Do Cancer Patients Decide to Withdraw Their Treatment? A Systematic Review and Meta-Synthesis
Background
Discontinuation of treatment by cancer patients is a complex decision driven by many factors that are not yet fully understood. Using a qualitative approach is the best way to explore this complexity in greater depth. Therefore, this study aimed to explore and synthesize the factors that influence the decision-making of cancer patients regarding withdrawal from treatment.
Methods
This is a qualitative systematic review and meta-synthesis, conducted using the six-step meta-synthesis method developed by Sandelowski and Barroso in 2007. Initially, a comprehensive systematic search was conducted in PubMed, Web of Science, Scopus, and CINAHL to identify relevant studies published between 2000 and 2024 according to our inclusion criteria. Subsequently, conventional content analysis was used to analyze the data extracted from qualitative studies. Initially, 348 studies were retrieved, and after screening, 18 studies were included in the meta-synthesis.
Results
From 177 primary codes, one main theme, two categories (endogenous and exogenous factors), and eight sub-categories were extracted through the meta-synthesis process. The factors affecting withdrawal from treatment were: “financial and insurance challenges,” “the communication role of the healthcare team,” “cultural and social factors,” “spiritual and religious beliefs,” “family functioning,” “personal attributes,” “the role of emotions,” and “medication side effects.”
Conclusion
The decision to withdraw from treatment is a multifaceted process influenced by personal values, clinical considerations, and social dynamics. A deeper understanding of these factors enables healthcare providers, especially nurses, to design better support programs.
期刊介绍：
Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas:
Clinical Cancer Research
Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations
Cancer Biology:
Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery.
Cancer Prevention:
Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach.
Bioinformatics:
Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers.
Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.
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